Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.65 / $76.14 / $76.14	Facility		$63.65	$76.14	$76.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $54.95 / $98.43	Professional		$40.15	$54.95	$98.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $62.81 / $96.23	Facility		$62.81	$62.81	$96.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.81 / $127.13 / $158.91	Professional		$62.81	$127.13	$158.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.59 / $107.01 / $113.40	Professional		$85.59	$107.01	$113.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $112.40 / $468.00	Facility		$54.95	$112.40	$468.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.82 / $49.31 / $119.53	Professional		$41.82	$49.31	$119.53
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.94 / $96.23 / $132.88	Facility		$95.94	$96.23	$132.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $78.80 / $113.72 / $183.89	Professional		$78.80	$113.72	$183.89
United Facility/Professional Professional Modifier Low / Median / High Price $41.82 / $43.64 / $103.00	Professional		$41.82	$43.64	$103.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $85.73 / $85.73 / $85.73	Facility		$85.73	$85.73	$85.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $85.73 / $85.73	Professional		$67.73	$85.73	$85.73