Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $112.20 / $123.03	Facility		$109.65	$112.20	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $83.18 / $131.83	Professional		$61.66	$83.18	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $199.53	Facility		$102.33	$102.33	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $181.97 / $229.09	Professional		$102.33	$181.97	$229.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $165.96 / $218.78	Professional		$144.54	$165.96	$218.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $204.17 / $741.31	Facility		$117.49	$204.17	$741.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $269.15	Professional		$75.86	$109.65	$269.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $204.17 / $234.42	Professional		$194.98	$204.17	$234.42
Midlands Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $302.00 / $302.00	Professional		$162.18	$302.00	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $93.33 / $229.09	Facility		$53.70	$93.33	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $158.49	Professional		$69.18	$89.13	$158.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $177.83 / $177.83	Professional		$138.04	$177.83	$177.83