Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $64.57	Facility		$44.67	$44.67	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $83.18	Professional		$30.90	$44.67	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $81.28	Facility		$52.48	$52.48	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $109.65 / $138.04	Professional		$52.48	$109.65	$138.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $83.18 / $93.33	Professional		$70.79	$83.18	$93.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $93.33 / $380.19	Facility		$48.98	$93.33	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $138.04	Professional		$33.88	$45.71	$138.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $81.28 / $109.65	Professional		$79.43	$81.28	$109.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $120.23 / $120.23	Professional		$83.18	$120.23	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $47.86 / $117.49	Facility		$27.54	$47.86	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $35.48 / $67.61	Professional		$33.88	$35.48	$67.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $70.79	Professional		$54.95	$70.79	$70.79