Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.01 / $123.01 / $146.38	Facility		$123.01	$123.01	$146.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $91.00 / $134.77	Professional		$62.10	$91.00	$134.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.79 / $97.79 / $168.77	Facility		$97.79	$97.79	$168.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.79 / $205.13 / $256.41	Professional		$97.79	$205.13	$256.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.59 / $150.90 / $177.04	Professional		$141.59	$150.90	$177.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.38 / $199.46 / $804.59	Facility		$96.38	$199.46	$804.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.34 / $85.05 / $209.61	Professional		$73.34	$85.05	$209.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $168.77 / $171.14 / $229.25	Facility		$168.77	$171.14	$229.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $152.80 / $199.46 / $322.47	Professional		$152.80	$199.46	$322.47
United Facility/Professional Facility Modifier Low / Median / High Price $62.18 / $74.61 / $89.55	Facility		$62.18	$74.61	$89.55
United Facility/Professional Professional Modifier Low / Median / High Price $73.34 / $76.54 / $180.44	Professional		$73.34	$76.54	$180.44
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $150.36 / $150.36 / $150.36	Facility		$150.36	$150.36	$150.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $118.78 / $150.36 / $150.36	Professional		$118.78	$150.36	$150.36