Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $107.15	Facility		$102.33	$102.33	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $102.33 / $128.82	Professional		$91.20	$102.33	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $144.54 / $147.91	Professional		$117.49	$144.54	$147.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $208.93	Professional		$95.50	$128.82	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $245.47 / $537.03	Facility		$97.72	$245.47	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $275.42	Professional		$112.20	$186.21	$275.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $245.47	Professional		$131.83	$154.88	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $275.42	Professional		$112.20	$186.21	$275.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $147.91 / $173.78	Professional		$117.49	$147.91	$173.78