Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.04 / $108.04 / $134.54	Facility		$108.04	$108.04	$134.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.08 / $83.30 / $123.88	Professional		$57.08	$83.30	$123.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.66 / $86.66 / $184.43	Facility		$86.66	$86.66	$184.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.66 / $180.38 / $225.47	Professional		$86.66	$180.38	$225.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.69 / $155.49 / $167.66	Professional		$138.69	$155.49	$167.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $105.32 / $210.70 / $735.04	Facility		$105.32	$210.70	$735.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.19 / $83.65 / $224.77	Professional		$69.19	$83.65	$224.77
Midlands Facility/Professional Facility Modifier Low / Median / High Price $183.89 / $184.43 / $221.04	Facility		$183.89	$184.43	$221.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.04 / $210.70 / $352.45	Professional		$151.04	$210.70	$352.45
United Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $83.65 / $202.14	Professional		$68.56	$83.65	$202.14
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $164.31 / $164.31 / $164.31	Facility		$164.31	$164.31	$164.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $129.80 / $164.31 / $164.31	Professional		$129.80	$164.31	$164.31