Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $151.36 / $151.36	Facility		$72.44	$151.36	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $70.79 / $87.10	Professional		$63.10	$70.79	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $128.82 / $162.18	Professional		$89.13	$128.82	$162.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $151.36	Professional		$67.61	$97.72	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $104.71 / $426.58	Facility		$67.61	$104.71	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $645.65	Professional		$79.43	$125.89	$645.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $269.15	Professional		$104.71	$165.96	$269.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $177.83	Professional		$79.43	$100.00	$177.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $162.18	Professional		$100.00	$120.23	$162.18