Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $457.09	Facility		$229.09	$229.09	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $389.05	Professional		$229.09	$229.09	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $295.12	Professional		$234.42	$234.42	$295.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $229.09 / $446.68	Professional		$162.18	$229.09	$446.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $229.09 / $346.74	Facility		$190.55	$229.09	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $229.09 / $338.84	Professional		$190.55	$229.09	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $288.40 / $288.40	Professional		$251.19	$288.40	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $229.09 / $239.88	Professional		$223.87	$229.09	$239.88
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09