Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.61 / $103.01 / $103.01	Facility		$92.61	$103.01	$103.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.74 / $76.45 / $113.69	Professional		$52.74	$76.45	$113.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.21 / $104.21 / $151.00	Facility		$104.21	$104.21	$151.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.65 / $171.75 / $214.69	Professional		$138.65	$171.75	$214.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $111.61 / $122.78 / $148.25	Professional		$111.61	$122.78	$148.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.23 / $175.12 / $670.46	Facility		$86.23	$175.12	$670.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.32 / $72.84 / $187.54	Professional		$63.32	$72.84	$187.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $150.55 / $151.00 / $193.38	Facility		$150.55	$151.00	$193.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.68 / $176.38 / $288.54	Professional		$123.68	$176.38	$288.54
United Facility/Professional Professional Modifier Low / Median / High Price $62.94 / $68.48 / $161.49	Professional		$62.94	$68.48	$161.49
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $134.52 / $134.52 / $134.52	Facility		$134.52	$134.52	$134.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $106.27 / $134.52 / $134.52	Professional		$106.27	$134.52	$134.52