Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.32 / $197.32 / $237.70	Facility		$197.32	$197.32	$237.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.40 / $182.05 / $272.49	Professional		$128.40	$182.05	$272.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.05 / $204.05 / $414.24	Facility		$204.05	$204.05	$414.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.88 / $393.26 / $446.89	Professional		$349.88	$393.26	$446.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $31.27 / $31.27	Professional		$28.69	$31.27	$31.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.89 / $513.44 / $1,464.56	Facility		$97.89	$513.44	$1,464.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.15 / $201.94 / $446.39	Professional		$158.15	$201.94	$446.39
Midlands Facility/Professional Facility Modifier Low / Median / High Price $41.42 / $41.42 / $97.89	Facility		$41.42	$41.42	$97.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.11 / $49.50 / $97.89	Professional		$41.11	$49.50	$97.89
United Facility/Professional Facility Modifier Low / Median / High Price $16.35 / $128.50 / $266.86	Facility		$16.35	$128.50	$266.86
United Facility/Professional Professional Modifier Low / Median / High Price $163.00 / $190.68 / $446.39	Professional		$163.00	$190.68	$446.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $267.75 / $338.92 / $338.92	Professional		$267.75	$338.92	$338.92