Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.66 / $139.66 / $312.99	Facility		$139.66	$139.66	$312.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $141.60 / $296.69	Professional		$139.66	$141.60	$296.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.26 / $144.26 / $144.26	Facility		$144.26	$144.26	$144.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.13 / $139.13 / $173.91	Professional		$139.13	$139.13	$173.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $256.30	Professional		$141.60	$141.60	$256.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.66 / $141.00 / $176.64	Facility		$139.66	$141.00	$176.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $127.84 / $141.00 / $203.82	Professional		$127.84	$141.00	$203.82
Midlands Facility/Professional Facility Modifier Low / Median / High Price $143.58 / $203.82 / $271.76	Facility		$143.58	$203.82	$271.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.18 / $156.43 / $222.85	Professional		$109.18	$156.43	$222.85
United Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $145.85	Professional		$141.60	$141.60	$145.85
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $141.00 / $141.00	Facility		$141.00	$141.00	$141.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.00 / $141.00 / $141.00	Professional		$141.00	$141.00	$141.00