Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.69 / $85.69 / $119.63	Facility		$85.69	$85.69	$119.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.72 / $74.06 / $110.15	Professional		$51.72	$74.06	$110.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.77 / $79.77 / $135.65	Facility		$79.77	$79.77	$135.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.77 / $142.88 / $178.59	Professional		$79.77	$142.88	$178.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.15 / $123.32 / $134.52	Professional		$117.15	$123.32	$134.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.47 / $158.46 / $647.48	Facility		$77.47	$158.46	$647.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.96 / $69.51 / $168.49	Professional		$58.96	$69.51	$168.49
Midlands Facility/Professional Facility Modifier Low / Median / High Price $135.26 / $135.65 / $187.35	Facility		$135.26	$135.65	$187.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $158.46 / $259.25	Professional		$120.00	$158.46	$259.25
United Facility/Professional Professional Modifier Low / Median / High Price $60.24 / $61.52 / $145.08	Professional		$60.24	$61.52	$145.08
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $120.85 / $120.85 / $120.85	Facility		$120.85	$120.85	$120.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.47 / $120.85 / $120.85	Professional		$95.47	$120.85	$120.85