Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.96 / $128.96 / $147.75	Facility		$128.96	$128.96	$147.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.43 / $101.86 / $184.16	Professional		$85.43	$101.86	$184.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.06 / $120.06 / $193.52	Facility		$120.06	$120.06	$193.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.06 / $215.25 / $269.06	Professional		$120.06	$215.25	$269.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $167.13 / $193.12 / $208.66	Professional		$167.13	$193.12	$208.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $110.52 / $226.07 / $878.76	Facility		$110.52	$226.07	$878.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $95.63 / $240.38	Professional		$83.86	$95.63	$240.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $192.97 / $193.52 / $257.64	Facility		$192.97	$193.52	$257.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.13 / $228.71 / $369.85	Professional		$173.13	$228.71	$369.85
United Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $87.77 / $230.77	Professional		$83.86	$87.77	$230.77
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $172.41 / $172.41 / $172.41	Facility		$172.41	$172.41	$172.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $136.19 / $172.41 / $172.41	Professional		$136.19	$172.41	$172.41