Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.41 / $71.41 / $74.14	Facility		$71.41	$71.41	$74.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.24 / $59.09 / $104.36	Professional		$43.24	$59.09	$104.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.48 / $61.48 / $114.39	Facility		$61.48	$61.48	$114.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.48 / $119.25 / $149.06	Professional		$61.48	$119.25	$149.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.63 / $102.77 / $109.20	Professional		$97.63	$102.77	$109.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $65.33 / $131.24 / $503.80	Facility		$65.33	$131.24	$503.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.65 / $55.46 / $142.09	Professional		$48.65	$55.46	$142.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $114.06 / $114.39 / $149.46	Facility		$114.06	$114.39	$149.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.68 / $133.62 / $218.61	Professional		$93.68	$133.62	$218.61
United Facility/Professional Facility Modifier Low / Median / High Price $29.60 / $29.60 / $29.60	Facility		$29.60	$29.60	$29.60
United Facility/Professional Professional Modifier Low / Median / High Price $48.65 / $51.88 / $136.41	Professional		$48.65	$51.88	$136.41
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $101.91 / $101.91 / $101.91	Facility		$101.91	$101.91	$101.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $80.51 / $101.91 / $101.91	Professional		$80.51	$101.91	$101.91