Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $87.40 / $167.92	Facility		$87.40	$87.40	$167.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $84.40 / $25,126.00	Professional		$75.97	$84.40	$25,126.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.78 / $84.51 / $89.72	Professional		$71.78	$84.51	$89.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.31 / $75.97 / $198.20	Professional		$53.31	$75.97	$198.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.86 / $84.51 / $141.38	Facility		$74.86	$84.51	$141.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.86 / $74.86 / $89.84	Professional		$74.86	$74.86	$89.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $84.51 / $118.37 / $172.77	Facility		$84.51	$118.37	$172.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.82 / $84.64 / $158.68	Professional		$83.82	$84.64	$158.68
United Facility/Professional Facility Modifier Low / Median / High Price $75.97 / $75.97 / $75.97	Facility		$75.97	$75.97	$75.97
United Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $78.25	Professional		$75.97	$75.97	$78.25
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $74.86 / $74.86 / $74.86	Facility		$74.86	$74.86	$74.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.86 / $74.86 / $74.86	Professional		$74.86	$74.86	$74.86