Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.98 / $67.98 / $94.90	Facility		$67.98	$67.98	$94.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $58.76 / $87.38	Professional		$40.26	$58.76	$87.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.18 / $72.18 / $107.61	Facility		$72.18	$72.18	$107.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.18 / $113.25 / $141.56	Professional		$72.18	$113.25	$141.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $92.94 / $116.59 / $155.19	Professional		$92.94	$116.59	$155.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.46 / $125.71 / $556.78	Facility		$61.46	$125.71	$556.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $56.41 / $133.66	Professional		$46.77	$56.41	$133.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $107.30 / $107.61 / $148.62	Facility		$107.30	$107.61	$148.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $125.71 / $205.65	Professional		$96.00	$125.71	$205.65
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $48.81 / $115.08	Professional		$46.77	$48.81	$115.08
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $95.87 / $95.87 / $95.87	Facility		$95.87	$95.87	$95.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.73 / $95.87 / $95.87	Professional		$75.73	$95.87	$95.87