Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $333.40 / $333.40 / $401.54	Facility		$333.40	$333.40	$401.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.64 / $308.61 / $460.41	Professional		$200.64	$308.61	$460.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.71 / $358.71 / $687.28	Facility		$358.71	$358.71	$687.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.71 / $612.38 / $765.47	Professional		$358.71	$612.38	$765.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.17 / $54.90 / $57.79	Professional		$50.17	$54.90	$57.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $832.32 / $2,574.69	Facility		$100.00	$832.32	$2,574.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.02 / $322.80 / $754.06	Professional		$270.02	$322.80	$754.06
Midlands Facility/Professional Facility Modifier Low / Median / High Price $68.73 / $68.73 / $162.44	Facility		$68.73	$68.73	$162.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $82.15 / $162.44	Professional		$68.20	$82.15	$162.44
United Facility/Professional Facility Modifier Low / Median / High Price $29.25 / $247.14 / $403.79	Facility		$29.25	$247.14	$403.79
United Facility/Professional Professional Modifier Low / Median / High Price $270.02 / $308.92 / $754.06	Professional		$270.02	$308.92	$754.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $444.23 / $562.32 / $562.32	Professional		$444.23	$562.32	$562.32