Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $381.72 / $381.72 / $834.47	Facility		$381.72	$381.72	$834.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $377.52 / $381.72 / $788.46	Professional		$377.52	$381.72	$788.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $377.44 / $377.44 / $471.80	Professional		$377.44	$377.44	$471.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $270.11 / $377.52 / $575.64	Professional		$270.11	$377.52	$575.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $242.00 / $381.72 / $480.96	Facility		$242.00	$381.72	$480.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $320.01 / $409.37 / $552.44	Professional		$320.01	$409.37	$552.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $311.10 / $554.95 / $771.27	Facility		$311.10	$554.95	$771.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $242.00 / $421.76 / $554.95	Professional		$242.00	$421.76	$554.95
United Facility/Professional Professional Modifier Low / Median / High Price $332.22 / $377.52 / $449.25	Professional		$332.22	$377.52	$449.25
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $376.48 / $376.48 / $376.48	Facility		$376.48	$376.48	$376.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $376.48 / $376.48 / $376.48	Professional		$376.48	$376.48	$376.48