Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $275.42	Facility		$234.42	$234.42	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $851.14	Professional		$169.82	$263.03	$851.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $426.58	Facility		$208.93	$208.93	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $436.52 / $549.54	Professional		$208.93	$436.52	$549.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $354.81 / $380.19	Professional		$302.00	$354.81	$380.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $446.68 / $1,778.28	Facility		$257.04	$446.68	$1,778.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $630.96	Professional		$169.82	$229.09	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $426.58 / $512.86	Professional		$416.87	$426.58	$512.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $630.96 / $630.96	Professional		$389.05	$630.96	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $281.84 / $549.54	Facility		$128.82	$281.84	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $186.21 / $346.74	Professional		$165.96	$186.21	$346.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $354.81 / $354.81	Professional		$281.84	$354.81	$354.81