Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.62 / $106.62 / $156.84	Facility		$106.62	$106.62	$156.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.50 / $80.87 / $147.04	Professional		$61.50	$80.87	$147.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.17 / $52.17 / $190.12	Facility		$52.17	$52.17	$190.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.17 / $151.88 / $190.12	Professional		$52.17	$151.88	$190.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $113.35 / $207.87 / $224.60	Professional		$113.35	$207.87	$224.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.45 / $223.82 / $580.79	Facility		$61.45	$223.82	$580.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.03 / $110.87 / $289.88	Professional		$95.03	$110.87	$289.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $190.12 / $191.04 / $259.23	Facility		$190.12	$191.04	$259.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $191.04 / $224.69 / $399.85	Professional		$191.04	$224.69	$399.85
United Facility/Professional Professional Modifier Low / Median / High Price $94.18 / $105.85 / $225.39	Professional		$94.18	$105.85	$225.39
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $169.38 / $169.38 / $169.38	Facility		$169.38	$169.38	$169.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $133.81 / $169.38 / $169.38	Professional		$133.81	$169.38	$169.38