Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $104.71 / $165.96	Facility		$83.18	$104.71	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $104.71	Professional		$83.18	$87.10	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $117.49	Professional		$95.50	$95.50	$117.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $151.36 / $173.78	Professional		$138.04	$151.36	$173.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $104.71 / $151.36	Facility		$95.50	$104.71	$151.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $151.36	Professional		$87.10	$87.10	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $104.71	Professional		$102.33	$102.33	$104.71
United Facility/Professional Facility Modifier Low / Median / High Price $0.09 / $0.09 / $169.82	Facility		$0.09	$0.09	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $91.20	Professional		$87.10	$87.10	$91.20
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10