Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $123.03 / $302.00	Facility		$81.28	$123.03	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $138.04	Professional		$81.28	$81.28	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $104.71	Professional		$83.18	$83.18	$104.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $181.97	Professional		$57.54	$87.10	$181.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $147.91	Facility		$81.28	$81.28	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $117.49	Professional		$81.28	$81.28	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $102.33	Professional		$87.10	$102.33	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $81.28 / $83.18	Professional		$77.62	$81.28	$83.18
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28