Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.97 / $97.97 / $118.13	Facility		$97.97	$97.97	$118.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.62 / $84.75 / $135.29	Professional		$67.62	$84.75	$135.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.70 / $88.70 / $147.24	Facility		$88.70	$88.70	$147.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.70 / $157.50 / $196.88	Professional		$88.70	$157.50	$196.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $15.55 / $15.55 / $32.46	Professional		$15.55	$15.55	$32.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.68 / $80.59 / $252.73	Facility		$21.68	$80.59	$252.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.10 / $41.27 / $162.19	Professional		$8.10	$41.27	$162.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $21.81 / $21.81 / $51.56	Facility		$21.81	$21.81	$51.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $21.68 / $26.08 / $51.56	Professional		$21.68	$26.08	$51.56
United Facility/Professional Professional Modifier Low / Median / High Price $8.10 / $63.90 / $153.91	Professional		$8.10	$63.90	$153.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $178.47 / $178.47	Professional		$140.99	$178.47	$178.47