Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.54 / $73.54 / $102.67	Facility		$73.54	$73.54	$102.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.56 / $63.57 / $98.26	Professional		$43.56	$63.57	$98.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.45 / $68.45 / $116.42	Facility		$68.45	$68.45	$116.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.45 / $122.63 / $153.28	Professional		$68.45	$122.63	$153.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.55 / $122.39 / $132.24	Professional		$100.55	$122.39	$132.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.48 / $136.00 / $594.69	Facility		$66.48	$136.00	$594.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.60 / $59.66 / $144.60	Professional		$50.60	$59.66	$144.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $116.08 / $116.42 / $160.79	Facility		$116.08	$116.42	$160.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $105.41 / $137.44 / $222.48	Professional		$105.41	$137.44	$222.48
United Facility/Professional Facility Modifier Low / Median / High Price $169.34 / $169.34 / $275.18	Facility		$169.34	$169.34	$275.18
United Facility/Professional Professional Modifier Low / Median / High Price $50.60 / $52.80 / $137.59	Professional		$50.60	$52.80	$137.59
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $103.72 / $103.72 / $103.72	Facility		$103.72	$103.72	$103.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.94 / $103.72 / $103.72	Professional		$81.94	$103.72	$103.72