Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $231.64 / $231.64 / $278.88	Facility		$231.64	$231.64	$278.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.27 / $212.52 / $319.89	Professional		$123.27	$212.52	$319.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $267.62 / $267.62 / $432.91	Facility		$267.62	$267.62	$432.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.62 / $445.88 / $569.38	Professional		$267.62	$445.88	$569.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $38.47 / $38.47	Professional		$36.54	$38.47	$38.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.34 / $456.04 / $1,807.28	Facility		$50.34	$456.04	$1,807.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $152.56 / $207.17 / $523.72	Professional		$152.56	$207.17	$523.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $43.30 / $43.30 / $102.34	Facility		$43.30	$43.30	$102.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $53.39 / $339.76	Professional		$42.97	$53.39	$339.76
United Facility/Professional Professional Modifier Low / Median / High Price $191.23 / $207.17 / $523.72	Professional		$191.23	$207.17	$523.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $279.82 / $354.20 / $354.20	Professional		$279.82	$354.20	$354.20