Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.87 / $79.87 / $176.55	Facility		$79.87	$79.87	$176.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.90 / $63.90 / $79.87	Professional		$63.90	$63.90	$79.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.63 / $25.78 / $25.78	Professional		$20.63	$25.78	$25.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.25 / $148.65 / $174.30	Professional		$25.25	$148.65	$174.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.00 / $79.87 / $143.68	Facility		$28.00	$79.87	$143.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $66.56 / $133.11	Professional		$35.47	$66.56	$133.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $28.00 / $97.42 / $133.11	Facility		$28.00	$97.42	$133.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $27.19 / $97.42 / $195.76	Professional		$27.19	$97.42	$195.76
United Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $66.56 / $66.56	Professional		$66.56	$66.56	$66.56
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $66.56 / $66.56 / $66.56	Facility		$66.56	$66.56	$66.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $66.56 / $66.56	Professional		$66.56	$66.56	$66.56