Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.96 / $161.96 / $195.06	Facility		$161.96	$161.96	$195.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.29 / $144.47 / $223.66	Professional		$99.29	$144.47	$223.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.31 / $166.31 / $328.88	Facility		$166.31	$166.31	$328.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.31 / $295.13 / $376.71	Professional		$166.31	$295.13	$376.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $24.17 / $25.44 / $25.45	Professional		$24.17	$25.44	$25.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.73 / $406.28 / $1,193.68	Facility		$77.73	$406.28	$1,193.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $127.66 / $156.16 / $382.11	Professional		$127.66	$156.16	$382.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $32.89 / $32.89 / $77.73	Facility		$32.89	$32.89	$77.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $39.31 / $77.73	Professional		$32.65	$39.31	$77.73
United Facility/Professional Professional Modifier Low / Median / High Price $133.76 / $146.02 / $366.32	Professional		$133.76	$146.02	$366.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $212.57 / $269.08 / $269.08	Professional		$212.57	$269.08	$269.08