Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.96 / $190.96 / $366.55	Facility		$190.96	$190.96	$366.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $190.96 / $293.27	Professional		$165.83	$190.96	$293.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.46 / $166.46 / $208.08	Professional		$166.46	$166.46	$208.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.21 / $165.83 / $256.19	Professional		$120.21	$165.83	$256.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.44 / $161.94 / $202.76	Facility		$147.44	$161.94	$202.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $159.87 / $161.96 / $202.76	Professional		$159.87	$161.96	$202.76
Midlands Facility/Professional Facility Modifier Low / Median / High Price $169.61 / $233.96 / $366.53	Facility		$169.61	$233.96	$366.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.75 / $182.39 / $264.02	Professional		$114.75	$182.39	$264.02
United Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $170.80	Professional		$165.83	$165.83	$170.80
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $161.96 / $161.96 / $161.96	Facility		$161.96	$161.96	$161.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $161.96 / $161.96 / $161.96	Professional		$161.96	$161.96	$161.96