Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.69 / $103.69 / $106.95	Facility		$103.69	$103.69	$106.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.94 / $103.69 / $129.19	Professional		$91.94	$103.69	$129.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.25 / $145.31 / $147.63	Professional		$116.25	$145.31	$147.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $96.27 / $110.02 / $187.55	Professional		$96.27	$110.02	$187.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.86 / $232.11 / $538.49	Facility		$39.86	$232.11	$538.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.51 / $205.07 / $275.33	Professional		$131.51	$205.07	$275.33
Midlands Facility/Professional Facility Modifier Low / Median / High Price $130.38 / $153.32 / $245.65	Facility		$130.38	$153.32	$245.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $130.38 / $174.06 / $262.11	Professional		$130.38	$174.06	$262.11
United Facility/Professional Professional Modifier Low / Median / High Price $97.60 / $187.60 / $275.33	Professional		$97.60	$187.60	$275.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $116.92 / $174.10 / $174.10	Professional		$116.92	$174.10	$174.10