Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $184.88 / $184.88 / $222.57	Facility		$184.88	$184.88	$222.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.83 / $184.88 / $255.31	Professional		$115.83	$184.88	$255.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $244.43 / $244.43 / $398.90	Facility		$244.43	$244.43	$398.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.34 / $358.88 / $448.59	Professional		$221.34	$358.88	$448.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.11 / $31.01 / $32.64	Professional		$26.11	$31.01	$32.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.37 / $377.47 / $1,550.44	Facility		$46.37	$377.47	$1,550.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.66 / $176.55 / $436.89	Professional		$120.66	$176.55	$436.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $34.53 / $39.90 / $94.30	Facility		$34.53	$39.90	$94.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $43.15 / $94.30	Professional		$34.43	$43.15	$94.30
United Facility/Professional Professional Modifier Low / Median / High Price $152.44 / $176.55 / $436.89	Professional		$152.44	$176.55	$436.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $257.83 / $326.38 / $326.38	Professional		$257.83	$326.38	$326.38