Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.45 / $72.45 / $236.22	Facility		$72.45	$72.45	$236.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $67.14 / $72.45	Professional		$67.14	$67.14	$72.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.93 / $69.93 / $69.93	Facility		$69.93	$69.93	$69.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.69 / $143.26 / $159.61	Professional		$127.69	$143.26	$159.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.32 / $125.32 / $226.83	Professional		$125.32	$125.32	$226.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.45 / $116.41 / $333.16	Facility		$72.45	$116.41	$333.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.93 / $69.93 / $121.78	Professional		$69.93	$69.93	$121.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $150.38 / $236.36 / $358.79	Facility		$150.38	$236.36	$358.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $150.38 / $150.38 / $162.79	Professional		$150.38	$150.38	$162.79
United Facility/Professional Professional Modifier Low / Median / High Price $46.67 / $46.67 / $48.07	Professional		$46.67	$46.67	$48.07
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $46.67 / $46.67 / $46.67	Facility		$46.67	$46.67	$46.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $46.67 / $46.67 / $46.67	Professional		$46.67	$46.67	$46.67