Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $74.13	Facility		$64.57	$64.57	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $102.33	Professional		$47.86	$57.54	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $117.49	Facility		$61.66	$61.66	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $120.23 / $147.91	Professional		$61.66	$120.23	$147.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $102.33 / $109.65	Professional		$95.50	$102.33	$109.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $131.83 / $501.19	Facility		$70.79	$131.83	$501.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $173.78	Professional		$48.98	$64.57	$173.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $120.23 / $147.91	Professional		$114.82	$120.23	$147.91
Midlands Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $173.78	Professional		$112.20	$173.78	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $64.57 / $162.18	Facility		$37.15	$64.57	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $95.50	Professional		$48.98	$51.29	$95.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $102.33	Professional		$81.28	$102.33	$102.33