Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $147.91	Facility		$109.65	$109.65	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $181.97	Professional		$79.43	$100.00	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $199.53	Facility		$120.23	$120.23	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $213.80 / $269.15	Professional		$120.23	$213.80	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $194.98 / $208.93	Professional		$158.49	$194.98	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $223.87 / $870.96	Facility		$120.23	$223.87	$870.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $295.12	Professional		$83.18	$112.20	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $199.53 / $257.04	Professional		$194.98	$199.53	$257.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $295.12	Professional		$194.98	$295.12	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $112.20 / $275.42	Facility		$64.57	$112.20	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $162.18	Professional		$83.18	$87.10	$162.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $173.78 / $173.78	Professional		$134.90	$173.78	$173.78