Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.85 / $87.85 / $87.85	Facility		$87.85	$87.85	$87.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.58 / $123.34 / $155.40	Professional		$80.58	$123.34	$155.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.38 / $30.47 / $30.47	Professional		$24.38	$30.47	$30.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.28 / $136.18 / $220.79	Facility		$109.28	$136.18	$220.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.86 / $132.60 / $214.20	Professional		$80.86	$132.60	$214.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.83 / $125.76 / $189.64	Facility		$102.83	$125.76	$189.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.69 / $125.76 / $193.24	Professional		$95.69	$125.76	$193.24
United Facility/Professional Professional Modifier Low / Median / High Price $80.86 / $123.32 / $204.00	Professional		$80.86	$123.32	$204.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $189.00 / $189.00 / $189.00	Professional		$189.00	$189.00	$189.00