Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.75 / $71.38 / $85.70	Professional		$64.75	$71.38	$85.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $127.50 / $167.40	Professional		$90.00	$127.50	$167.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.36 / $106.39 / $162.47	Professional		$70.36	$106.39	$162.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.73 / $105.58 / $424.81	Facility		$67.73	$105.58	$424.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.72 / $125.39 / $483.84	Professional		$83.72	$125.39	$483.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $120.33 / $140.75 / $192.69	Facility		$120.33	$140.75	$192.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $105.58 / $140.75 / $224.04	Professional		$105.58	$140.75	$224.04
United Facility/Professional Professional Modifier Low / Median / High Price $79.89 / $95.36 / $176.73	Professional		$79.89	$95.36	$176.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $99.80 / $117.40 / $163.30	Professional		$99.80	$117.40	$163.30