Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $219.92 / $219.92 / $486.11	Facility		$219.92	$219.92	$486.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.94 / $175.94 / $219.92	Professional		$175.94	$175.94	$219.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6.75 / $8.44 / $8.44	Professional		$6.75	$8.44	$8.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $4.25 / $139.97 / $261.41	Professional		$4.25	$139.97	$261.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.58 / $19.05 / $222.77	Facility		$13.58	$19.05	$222.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $183.26 / $188.76	Professional		$14.00	$183.26	$188.76
Midlands Facility/Professional Facility Modifier Low / Median / High Price $13.58 / $19.05 / $220.10	Facility		$13.58	$19.05	$220.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $12.82 / $16.36 / $29.28	Professional		$12.82	$16.36	$29.28
United Facility/Professional Facility Modifier Low / Median / High Price $0.18 / $0.18 / $0.18	Facility		$0.18	$0.18	$0.18
United Facility/Professional Professional Modifier Low / Median / High Price $183.26 / $183.26 / $188.76	Professional		$183.26	$183.26	$188.76
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $183.26 / $183.26 / $183.26	Facility		$183.26	$183.26	$183.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $183.26 / $183.26 / $183.26	Professional		$183.26	$183.26	$183.26