Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $457.09 / $776.25	Facility		$389.05	$457.09	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $407.38 / $660.69	Professional		$389.05	$407.38	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $501.19	Professional		$398.11	$398.11	$501.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $389.05 / $407.38	Professional		$151.36	$389.05	$407.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $389.05 / $588.84	Facility		$123.03	$389.05	$588.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $389.05 / $575.44	Professional		$181.97	$389.05	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $501.19	Professional		$426.58	$501.19	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $389.05 / $407.38	Professional		$380.19	$389.05	$407.38
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05