Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $125.89	Facility		$107.15	$107.15	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $154.88	Professional		$70.79	$91.20	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $194.98	Facility		$104.71	$104.71	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $199.53 / $251.19	Professional		$104.71	$199.53	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $173.78 / $181.97	Professional		$147.91	$173.78	$181.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $204.17 / $812.83	Facility		$117.49	$204.17	$812.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $288.40	Professional		$77.62	$104.71	$288.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $194.98 / $234.42	Professional		$190.55	$194.98	$234.42
Midlands Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $288.40 / $288.40	Professional		$177.83	$288.40	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $128.82 / $251.19	Facility		$58.88	$128.82	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $158.49	Professional		$75.86	$85.11	$158.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $169.82	Professional		$131.83	$169.82	$169.82