Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.80 / $73.80 / $88.45	Facility		$73.80	$73.80	$88.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.56 / $66.23 / $101.43	Professional		$42.56	$66.23	$101.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.15 / $78.15 / $146.65	Facility		$78.15	$78.15	$146.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.15 / $118.31 / $172.50	Professional		$78.15	$118.31	$172.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $11.30 / $11.89 / $12.40	Professional		$11.30	$11.89	$12.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.65 / $157.25 / $560.90	Facility		$34.65	$157.25	$560.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.93 / $65.30 / $166.09	Professional		$49.93	$65.30	$166.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $14.66 / $14.66 / $34.65	Facility		$14.66	$14.66	$34.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $14.54 / $17.52 / $34.65	Professional		$14.54	$17.52	$34.65
United Facility/Professional Professional Modifier Low / Median / High Price $57.68 / $65.06 / $166.09	Professional		$57.68	$65.06	$166.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.79 / $119.99 / $119.99	Professional		$94.79	$119.99	$119.99