Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.30 / $96.30 / $109.45	Facility		$96.30	$96.30	$109.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.42 / $83.24 / $123.79	Professional		$57.42	$83.24	$123.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.65 / $89.65 / $152.46	Facility		$89.65	$89.65	$152.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.65 / $160.50 / $200.63	Professional		$89.65	$160.50	$200.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $131.66 / $174.69 / $188.75	Professional		$131.66	$174.69	$188.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.07 / $178.09 / $737.38	Facility		$87.07	$178.09	$737.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.26 / $78.11 / $189.36	Professional		$66.26	$78.11	$189.36
Midlands Facility/Professional Facility Modifier Low / Median / High Price $152.01 / $152.46 / $210.54	Facility		$152.01	$152.46	$210.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.22 / $178.09 / $291.33	Professional		$128.22	$178.09	$291.33
United Facility/Professional Professional Modifier Low / Median / High Price $66.26 / $71.45 / $177.80	Professional		$66.26	$71.45	$177.80
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $135.83 / $135.83 / $135.83	Facility		$135.83	$135.83	$135.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.31 / $135.83 / $135.83	Professional		$107.31	$135.83	$135.83