Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $140.00 / $140.00	Facility		$140.00	$140.00	$140.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $140.00 / $140.00	Professional		$140.00	$140.00	$140.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.29 / $223.29 / $223.29	Facility		$223.29	$223.29	$223.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.00 / $223.29 / $332.76	Professional		$163.00	$223.29	$332.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $369.60 / $369.60	Professional		$150.00	$369.60	$369.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $238.00 / $287.00	Facility		$140.00	$238.00	$287.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $170.65 / $185.16 / $355.92	Professional		$170.65	$185.16	$355.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $280.68 / $280.68 / $280.68	Facility		$280.68	$280.68	$280.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $244.64 / $244.64 / $280.68	Professional		$244.64	$244.64	$280.68
United Facility/Professional Professional Modifier Low / Median / High Price $170.65 / $184.87 / $355.92	Professional		$170.65	$184.87	$355.92
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $233.70 / $233.70 / $233.70	Facility		$233.70	$233.70	$233.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $184.62 / $233.70 / $233.70	Professional		$184.62	$233.70	$233.70