Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.23 / $84.00 / $84.00	Facility		$68.23	$84.00	$84.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.26 / $58.92 / $88.93	Professional		$41.26	$58.92	$88.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.68 / $71.68 / $103.18	Facility		$71.68	$71.68	$103.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.68 / $140.25 / $175.31	Professional		$71.68	$140.25	$175.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.28 / $93.80 / $120.89	Professional		$89.28	$93.80	$120.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.92 / $120.53 / $496.97	Facility		$58.92	$120.53	$496.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.84 / $52.87 / $128.15	Professional		$44.84	$52.87	$128.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.88 / $103.18 / $142.51	Facility		$102.88	$103.18	$142.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.50 / $121.94 / $197.17	Professional		$84.50	$121.94	$197.17
United Facility/Professional Facility Modifier Low / Median / High Price $150.08 / $150.08 / $243.89	Facility		$150.08	$150.08	$243.89
United Facility/Professional Professional Modifier Low / Median / High Price $45.82 / $46.79 / $110.30	Professional		$45.82	$46.79	$110.30
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $91.92 / $91.92 / $91.92	Facility		$91.92	$91.92	$91.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $72.62 / $91.92 / $91.92	Professional		$72.62	$91.92	$91.92