Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.73 / $67.73 / $86.97	Facility		$67.73	$67.73	$86.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $55.42 / $89.13	Professional		$37.97	$55.42	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.72 / $62.72 / $104.05	Facility		$62.72	$62.72	$104.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.72 / $112.88 / $141.09	Professional		$62.72	$112.88	$141.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.86 / $106.92 / $115.86	Professional		$89.86	$106.92	$115.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.42 / $121.54 / $490.51	Facility		$59.42	$121.54	$490.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.22 / $53.70 / $129.22	Professional		$45.22	$53.70	$129.22
Midlands Facility/Professional Facility Modifier Low / Median / High Price $103.74 / $104.05 / $140.15	Facility		$103.74	$104.05	$140.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $94.20 / $122.97 / $198.82	Professional		$94.20	$122.97	$198.82
United Facility/Professional Facility Modifier Low / Median / High Price $147.61 / $147.61 / $239.87	Facility		$147.61	$147.61	$239.87
United Facility/Professional Professional Modifier Low / Median / High Price $45.22 / $47.18 / $111.36	Professional		$45.22	$47.18	$111.36
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $92.70 / $92.70 / $92.70	Facility		$92.70	$92.70	$92.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $92.70 / $92.70	Professional		$73.23	$92.70	$92.70