Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.37 / $130.85 / $130.85	Facility		$128.37	$130.85	$130.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.62 / $105.98 / $179.33	Professional		$72.62	$105.98	$179.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.82 / $121.82 / $215.83	Facility		$121.82	$121.82	$215.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.82 / $218.25 / $272.81	Professional		$121.82	$218.25	$272.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $170.67 / $203.20 / $220.20	Professional		$170.67	$203.20	$220.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.26 / $225.84 / $928.37	Facility		$123.26	$225.84	$928.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.03 / $101.74 / $268.04	Professional		$88.03	$101.74	$268.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $215.20 / $215.83 / $268.04	Facility		$215.20	$215.83	$268.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $176.75 / $252.11 / $412.39	Professional		$176.75	$252.11	$412.39
United Facility/Professional Professional Modifier Low / Median / High Price $87.24 / $97.88 / $230.90	Professional		$87.24	$97.88	$230.90
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $192.29 / $192.29 / $192.29	Facility		$192.29	$192.29	$192.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.91 / $192.29 / $192.29	Professional		$151.91	$192.29	$192.29