Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $203.68	Facility		$150.00	$150.00	$203.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.41 / $126.11 / $187.54	Professional		$86.41	$126.11	$187.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.66 / $139.66 / $230.97	Facility		$139.66	$139.66	$230.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $250.13 / $312.66	Professional		$139.66	$250.13	$312.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $199.47 / $221.99 / $240.56	Professional		$199.47	$221.99	$240.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $269.80 / $1,100.50	Facility		$131.90	$269.80	$1,100.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.38 / $118.35 / $286.89	Professional		$100.38	$118.35	$286.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $230.30 / $230.97 / $318.97	Facility		$230.30	$230.97	$318.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $209.13 / $269.80 / $441.38	Professional		$209.13	$269.80	$441.38
United Facility/Professional Professional Modifier Low / Median / High Price $100.38 / $104.75 / $247.00	Professional		$100.38	$104.75	$247.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $205.77 / $205.77 / $205.77	Facility		$205.77	$205.77	$205.77
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.56 / $205.77 / $205.77	Professional		$162.56	$205.77	$205.77