Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.44 / $101.44 / $165.11	Facility		$101.44	$101.44	$165.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $101.44 / $201.35	Professional		$64.62	$101.44	$201.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $79.15 / $84.00	Professional		$67.20	$79.15	$84.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.72 / $64.62 / $306.52	Professional		$42.72	$64.62	$306.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $90.06 / $104.55	Facility		$10.00	$90.06	$104.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.02 / $75.05 / $104.55	Professional		$30.02	$75.05	$104.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $90.06 / $133.29	Facility		$10.00	$90.06	$133.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $12.57 / $90.06 / $136.29	Professional		$12.57	$90.06	$136.29
United Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $64.62 / $65.91	Professional		$64.62	$64.62	$65.91
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $75.05 / $75.05 / $75.05	Facility		$75.05	$75.05	$75.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.05 / $75.05 / $75.05	Professional		$75.05	$75.05	$75.05