Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.70 / $101.70 / $107.69	Facility		$101.70	$101.70	$107.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.78 / $78.52 / $131.44	Professional		$58.78	$78.52	$131.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $81.70 / $160.19	Facility		$81.70	$81.70	$160.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.70 / $169.50 / $211.88	Professional		$81.70	$169.50	$211.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.36 / $152.40 / $165.15	Professional		$138.36	$152.40	$165.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.50 / $187.15 / $681.55	Facility		$91.50	$187.15	$681.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.23 / $75.38 / $198.63	Professional		$65.23	$75.38	$198.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $159.74 / $160.19 / $198.63	Facility		$159.74	$160.19	$198.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.19 / $187.15 / $306.16	Professional		$131.19	$187.15	$306.16
United Facility/Professional Professional Modifier Low / Median / High Price $64.64 / $72.66 / $190.28	Professional		$64.64	$72.66	$190.28
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $142.72 / $142.72 / $142.72	Facility		$142.72	$142.72	$142.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.76 / $142.72 / $142.72	Professional		$112.76	$142.72	$142.72