Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $61.66 / $109.65	Facility		$54.95	$61.66	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $57.54 / $93.33	Professional		$53.70	$57.54	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $58.88 / $69.18	Professional		$54.95	$58.88	$69.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $64.57 / $257.04	Professional		$41.69	$64.57	$257.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $61.66 / $93.33	Facility		$54.95	$61.66	$93.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $93.33	Professional		$54.95	$54.95	$93.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $72.44 / $72.44	Professional		$66.07	$72.44	$72.44
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $57.54	Professional		$54.95	$54.95	$57.54
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95