Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $645.65 / $851.14	Facility		$123.03	$645.65	$851.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $2,630.27	Professional		$123.03	$169.82	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $154.88	Professional		$125.89	$125.89	$154.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $389.05 / $1,071.52	Professional		$89.13	$389.05	$1,071.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $58.88 / $645.65	Facility		$23.99	$58.88	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $60.26 / $102.33	Professional		$30.20	$60.26	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $162.18	Professional		$25.70	$25.70	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $125.89 / $144.54	Professional		$123.03	$125.89	$144.54
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13