Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.95 / $74.23 / $74.23	Facility		$63.95	$74.23	$74.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.60 / $54.91 / $102.72	Professional		$38.60	$54.91	$102.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.78 / $66.78 / $97.74	Facility		$66.78	$66.78	$97.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.78 / $123.75 / $154.69	Professional		$66.78	$123.75	$154.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.46 / $106.82 / $115.02	Professional		$85.46	$106.82	$115.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.82 / $114.17 / $471.51	Facility		$55.82	$114.17	$471.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $49.54 / $121.38	Professional		$42.47	$49.54	$121.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $97.74 / $98.00 / $133.52	Facility		$97.74	$98.00	$133.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $80.03 / $115.51 / $186.75	Professional		$80.03	$115.51	$186.75
United Facility/Professional Facility Modifier Low / Median / High Price $140.62 / $140.62 / $228.50	Facility		$140.62	$140.62	$228.50
United Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $44.32 / $104.48	Professional		$42.47	$44.32	$104.48
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $87.07 / $87.07 / $87.07	Facility		$87.07	$87.07	$87.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.79 / $87.07 / $87.07	Professional		$68.79	$87.07	$87.07