Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.18 / $102.18 / $105.55	Facility		$102.18	$102.18	$105.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.20 / $76.05 / $117.93	Professional		$56.20	$76.05	$117.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.98 / $92.98 / $166.98	Facility		$92.98	$92.98	$166.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.54 / $170.63 / $213.28	Professional		$137.54	$170.63	$213.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $129.03 / $171.62 / $182.63	Professional		$129.03	$171.62	$182.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.36 / $174.77 / $659.83	Facility		$95.36	$174.77	$659.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.16 / $75.73 / $199.11	Professional		$63.16	$75.73	$199.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $166.49 / $166.98 / $200.12	Facility		$166.49	$166.98	$200.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $192.33 / $319.08	Professional		$136.00	$192.33	$319.08
United Facility/Professional Professional Modifier Low / Median / High Price $62.60 / $75.73 / $191.18	Professional		$62.60	$75.73	$191.18
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $148.76 / $148.76 / $148.76	Facility		$148.76	$148.76	$148.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $117.52 / $148.76 / $148.76	Professional		$117.52	$148.76	$148.76