Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.00 / $243.00 / $472.67	Facility		$243.00	$243.00	$472.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $237.57 / $320.54	Professional		$213.84	$237.57	$320.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.86 / $217.87 / $267.33	Professional		$213.86	$217.87	$267.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $148.22 / $213.84 / $388.80	Professional		$148.22	$213.84	$388.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $212.36 / $243.00 / $323.26	Facility		$212.36	$243.00	$323.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $212.36 / $212.36 / $314.83	Professional		$212.36	$212.36	$314.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $251.87 / $314.83 / $493.24	Facility		$251.87	$314.83	$493.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.27 / $254.84 / $314.83	Professional		$239.27	$254.84	$314.83
United Facility/Professional Facility Modifier Low / Median / High Price $0.21 / $0.21 / $0.21	Facility		$0.21	$0.21	$0.21
United Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $220.26	Professional		$213.84	$213.84	$220.26
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $212.36 / $212.36 / $212.36	Facility		$212.36	$212.36	$212.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $212.36 / $212.36 / $212.36	Professional		$212.36	$212.36	$212.36