Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.31 / $81.31 / $85.16	Facility		$81.31	$81.31	$85.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.17 / $63.26 / $104.53	Professional		$48.17	$63.26	$104.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.70 / $75.70 / $128.74	Facility		$75.70	$75.70	$128.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $135.75 / $169.69	Professional		$109.44	$135.75	$169.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.04 / $123.29 / $133.22	Professional		$117.04	$123.29	$133.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.52 / $138.24 / $547.75	Facility		$73.52	$138.24	$547.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.55 / $60.60 / $159.91	Professional		$52.55	$60.60	$159.91
Midlands Facility/Professional Facility Modifier Low / Median / High Price $128.37 / $128.74 / $160.02	Facility		$128.37	$128.74	$160.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $105.43 / $150.38 / $246.03	Professional		$105.43	$150.38	$246.03
United Facility/Professional Professional Modifier Low / Median / High Price $55.95 / $58.39 / $138.63	Professional		$55.95	$58.39	$138.63
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $114.70 / $114.70 / $114.70	Facility		$114.70	$114.70	$114.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $90.61 / $114.70 / $114.70	Professional		$90.61	$114.70	$114.70