Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $79.43	Facility		$54.95	$54.95	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $53.70 / $77.62	Professional		$34.67	$53.70	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $100.00	Facility		$53.70	$53.70	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $134.90 / $165.96	Professional		$53.70	$134.90	$165.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $114.82	Professional		$85.11	$107.15	$114.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $114.82 / $457.09	Facility		$60.26	$114.82	$457.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $165.96	Professional		$42.66	$56.23	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $102.33 / $131.83	Professional		$97.72	$102.33	$131.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $147.91	Professional		$100.00	$147.91	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $72.44 / $141.25	Facility		$33.11	$72.44	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $44.67 / $85.11	Professional		$42.66	$44.67	$85.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $87.10	Professional		$69.18	$87.10	$87.10