Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $83.18	Facility		$57.54	$57.54	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $87.10	Professional		$40.74	$57.54	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $104.71	Facility		$72.44	$72.44	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $141.25 / $173.78	Professional		$72.44	$141.25	$173.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $120.23	Professional		$89.13	$93.33	$120.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $120.23 / $501.19	Facility		$64.57	$120.23	$501.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $60.26 / $177.83	Professional		$44.67	$60.26	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $107.15 / $141.25	Professional		$102.33	$107.15	$141.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $158.49	Professional		$107.15	$158.49	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $63.10 / $151.36	Facility		$36.31	$63.10	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $46.77 / $89.13	Professional		$45.71	$46.77	$89.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $91.20	Professional		$72.44	$91.20	$91.20