Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.68 / $67.68 / $149.60	Facility		$67.68	$67.68	$149.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.14 / $54.14 / $67.68	Professional		$54.14	$54.14	$67.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.40 / $56.40 / $56.40	Facility		$56.40	$56.40	$56.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.40 / $59.61 / $70.50	Professional		$56.40	$59.61	$70.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $158.91 / $162.27	Professional		$138.38	$158.91	$162.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $1.00 / $67.68 / $91.50	Facility		$1.00	$67.68	$91.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.40 / $56.40 / $58.09	Professional		$56.40	$56.40	$58.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1.00 / $97.07 / $123.54	Facility		$1.00	$97.07	$123.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $67.73 / $67.73	Professional		$67.73	$67.73	$67.73
United Facility/Professional Professional Modifier Low / Median / High Price $56.40 / $56.40 / $58.09	Professional		$56.40	$56.40	$58.09
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $56.40 / $56.40 / $56.40	Facility		$56.40	$56.40	$56.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.40 / $56.40 / $56.40	Professional		$56.40	$56.40	$56.40