Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.75 / $93.92 / $93.92	Facility		$73.75	$93.92	$93.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.67 / $63.68 / $102.58	Professional		$51.67	$63.68	$102.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.42 / $87.42 / $111.52	Facility		$87.42	$87.42	$111.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.42 / $156.75 / $195.94	Professional		$87.42	$156.75	$195.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $114.89 / $135.16	Professional		$97.62	$114.89	$135.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.68 / $130.26 / $540.12	Facility		$63.68	$130.26	$540.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $57.57 / $138.51	Professional		$48.46	$57.57	$138.51
Midlands Facility/Professional Facility Modifier Low / Median / High Price $111.52 / $112.00 / $154.01	Facility		$111.52	$112.00	$154.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.32 / $131.79 / $213.09	Professional		$91.32	$131.79	$213.09
United Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $52.26 / $130.05	Professional		$48.46	$52.26	$130.05
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $99.35 / $99.35 / $99.35	Facility		$99.35	$99.35	$99.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.48 / $99.35 / $99.35	Professional		$78.48	$99.35	$99.35