Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.29 / $135.29 / $259.41	Facility		$135.29	$135.29	$259.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $135.29 / $280.02	Professional		$117.36	$135.29	$280.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.59 / $119.59 / $119.59	Facility		$119.59	$119.59	$119.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.69 / $118.69 / $148.36	Professional		$118.69	$118.69	$148.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $150.00 / $231.50	Professional		$117.36	$150.00	$231.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.19 / $135.29 / $179.37	Facility		$117.19	$135.29	$179.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.19 / $117.19 / $173.20	Professional		$117.19	$117.19	$173.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $138.56 / $173.21 / $271.35	Facility		$138.56	$173.21	$271.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.63 / $140.63 / $173.20	Professional		$131.63	$140.63	$173.20
United Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $120.88	Professional		$117.36	$117.36	$120.88
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $117.19 / $117.19 / $117.19	Facility		$117.19	$117.19	$117.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $117.19 / $117.19 / $117.19	Professional		$117.19	$117.19	$117.19