Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.99 / $110.99 / $124.99	Facility		$110.99	$110.99	$124.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $82.10 / $117.84	Professional		$55.31	$82.10	$117.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.32 / $103.32 / $146.26	Facility		$103.32	$103.32	$146.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.32 / $185.25 / $231.56	Professional		$103.32	$185.25	$231.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $126.55 / $158.94 / $168.44	Professional		$126.55	$158.94	$168.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.52 / $172.85 / $709.25	Facility		$83.52	$172.85	$709.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $74.36 / $181.66	Professional		$63.56	$74.36	$181.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $146.26 / $148.30 / $200.43	Facility		$146.26	$148.30	$200.43
Midlands Facility/Professional Professional Modifier Low / Median / High Price $132.41 / $172.85 / $279.48	Professional		$132.41	$172.85	$279.48
United Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $66.33 / $156.44	Professional		$63.56	$66.33	$156.44
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $130.30 / $130.30 / $130.30	Facility		$130.30	$130.30	$130.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $130.30 / $130.30	Professional		$102.94	$130.30	$130.30