Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.76 / $81.76 / $97.99	Facility		$81.76	$81.76	$97.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $72.58 / $112.38	Professional		$46.76	$72.58	$112.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $160.94	Facility		$45.00	$45.00	$160.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $153.38 / $195.68	Professional		$45.00	$153.38	$195.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.56 / $13.22 / $13.56	Professional		$12.56	$13.22	$13.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.11 / $172.85 / $615.09	Facility		$38.11	$172.85	$615.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.86 / $71.73 / $184.02	Professional		$54.86	$71.73	$184.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $16.13 / $16.13 / $38.11	Facility		$16.13	$16.13	$38.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $19.26 / $38.11	Professional		$16.00	$19.26	$38.11
United Facility/Professional Professional Modifier Low / Median / High Price $59.85 / $71.73 / $184.02	Professional		$59.85	$71.73	$184.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $131.69 / $131.69	Professional		$104.04	$131.69	$131.69