Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.61 / $124.61 / $231.50	Facility		$124.61	$124.61	$231.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $124.61 / $241.04	Professional		$104.73	$124.61	$241.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.38 / $102.38 / $127.97	Professional		$102.38	$102.38	$127.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $150.00 / $412.67	Professional		$104.73	$150.00	$412.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.95 / $120.60 / $130.94	Facility		$104.95	$120.60	$130.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.95 / $104.95 / $151.09	Professional		$104.95	$104.95	$151.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $110.80 / $151.10 / $201.46	Facility		$110.80	$151.10	$201.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.83 / $125.94 / $234.67	Professional		$114.83	$125.94	$234.67
United Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $107.87	Professional		$104.73	$104.73	$107.87
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $104.95 / $104.95 / $104.95	Facility		$104.95	$104.95	$104.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.95 / $104.95 / $104.95	Professional		$104.95	$104.95	$104.95