Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.64 / $107.64 / $142.44	Facility		$107.64	$107.64	$142.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.06 / $101.18 / $155.79	Professional		$63.06	$101.18	$155.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $198.95	Facility		$133.72	$133.72	$198.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.72 / $183.12 / $228.90	Professional		$133.72	$183.12	$228.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $119.94 / $217.09 / $238.03	Professional		$119.94	$217.09	$238.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $101.18 / $235.12 / $620.42	Facility		$101.18	$235.12	$620.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.68 / $113.63 / $284.89	Professional		$97.68	$113.63	$284.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $198.95 / $214.81 / $271.36	Facility		$198.95	$214.81	$271.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $198.59 / $235.12 / $418.67	Professional		$198.59	$235.12	$418.67
United Facility/Professional Professional Modifier Low / Median / High Price $96.81 / $109.97 / $259.43	Professional		$96.81	$109.97	$259.43
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $177.24 / $177.24 / $177.24	Facility		$177.24	$177.24	$177.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $140.02 / $177.24 / $177.24	Professional		$140.02	$177.24	$177.24