Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.00 / $192.00 / $424.40	Facility		$192.00	$192.00	$424.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.60 / $153.60 / $192.00	Professional		$153.60	$153.60	$192.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $160.00 / $160.00	Facility		$160.00	$160.00	$160.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.01 / $169.10 / $200.02	Professional		$160.01	$169.10	$200.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $197.03 / $201.18	Professional		$150.00	$197.03	$201.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $1.00 / $192.00 / $259.58	Facility		$1.00	$192.00	$259.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $164.80	Professional		$160.00	$160.00	$164.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $0.90 / $1.00 / $192.16	Facility		$0.90	$1.00	$192.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $192.16 / $192.16 / $192.16	Professional		$192.16	$192.16	$192.16
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $163.19	Professional		$160.00	$160.00	$163.19
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $160.00 / $160.00	Facility		$160.00	$160.00	$160.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $160.00	Professional		$160.00	$160.00	$160.00