Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $263.03 / $446.68	Facility		$223.87	$263.03	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $239.88 / $380.19	Professional		$223.87	$239.88	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $234.42 / $288.40	Professional		$229.09	$234.42	$288.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $223.87 / $467.74	Professional		$158.49	$223.87	$467.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $263.03 / $338.84	Facility		$223.87	$263.03	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $331.13	Professional		$223.87	$223.87	$331.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $288.40	Professional		$269.15	$288.40	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $223.87 / $229.09	Professional		$218.78	$223.87	$229.09
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87