Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.47 / $89.47 / $124.91	Facility		$89.47	$89.47	$124.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.35 / $77.34 / $115.01	Professional		$53.35	$77.34	$115.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $80.45 / $141.63	Facility		$80.45	$80.45	$141.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $149.25 / $186.56	Professional		$80.45	$149.25	$186.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $101.90 / $110.10 / $128.76	Professional		$101.90	$110.10	$128.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.89 / $165.46 / $675.46	Facility		$80.89	$165.46	$675.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $61.55 / $72.56 / $175.92	Professional		$61.55	$72.56	$175.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $141.22 / $141.63 / $195.61	Facility		$141.22	$141.63	$195.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $165.46 / $270.67	Professional		$126.00	$165.46	$270.67
United Facility/Professional Professional Modifier Low / Median / High Price $61.55 / $64.34 / $168.89	Professional		$61.55	$64.34	$168.89
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $126.18 / $126.18 / $126.18	Facility		$126.18	$126.18	$126.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $99.68 / $126.18 / $126.18	Professional		$99.68	$126.18	$126.18