Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $218.78 / $218.78	Facility		$104.71	$218.78	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $102.33 / $120.23	Professional		$91.20	$102.33	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $223.87	Professional		$131.83	$173.78	$223.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $208.93	Professional		$97.72	$134.90	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $147.91 / $616.60	Facility		$97.72	$147.91	$616.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $891.25	Professional		$112.20	$177.83	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $229.09 / $363.08	Professional		$151.36	$229.09	$363.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $251.19	Professional		$112.20	$141.25	$251.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $173.78 / $223.87	Professional		$144.54	$173.78	$223.87