Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.04 / $104.04 / $229.97	Facility		$104.04	$104.04	$229.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.23 / $83.23 / $104.04	Professional		$83.23	$83.23	$104.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.50 / $94.50 / $118.13	Professional		$94.50	$94.50	$118.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $137.97 / $160.83 / $174.30	Professional		$137.97	$160.83	$174.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.72 / $104.04 / $149.83	Facility		$94.72	$104.04	$149.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $149.83	Professional		$86.70	$86.70	$149.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.72 / $104.13 / $138.80	Facility		$94.72	$104.13	$138.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $94.72 / $115.41 / $204.11	Professional		$94.72	$115.41	$204.11
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $89.30	Professional		$86.70	$86.70	$89.30
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Facility		$86.70	$86.70	$86.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Professional		$86.70	$86.70	$86.70