Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $138.04 / $138.04	Facility		$67.61	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $66.07 / $81.28	Professional		$57.54	$66.07	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $147.91	Professional		$81.28	$117.49	$147.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $147.91	Professional		$61.66	$91.20	$147.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $97.72 / $389.05	Facility		$61.66	$97.72	$389.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $588.84	Professional		$77.62	$120.23	$588.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $154.88 / $245.47	Professional		$97.72	$154.88	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $169.82	Professional		$75.86	$97.72	$169.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $109.65 / $151.36	Professional		$91.20	$109.65	$151.36