Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.73 / $110.73 / $117.21	Facility		$110.73	$110.73	$117.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.01 / $85.50 / $143.10	Professional		$64.01	$85.50	$143.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.96 / $88.96 / $174.44	Facility		$88.96	$88.96	$174.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.96 / $184.88 / $231.09	Professional		$88.96	$184.88	$231.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $159.80 / $172.66	Professional		$150.00	$159.80	$172.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.62 / $199.74 / $742.11	Facility		$99.62	$199.74	$742.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.02 / $82.08 / $216.26	Professional		$71.02	$82.08	$216.26
Midlands Facility/Professional Facility Modifier Low / Median / High Price $173.92 / $174.44 / $216.26	Facility		$173.92	$174.44	$216.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $142.85 / $203.77 / $333.33	Professional		$142.85	$203.77	$333.33
United Facility/Professional Professional Modifier Low / Median / High Price $70.39 / $79.12 / $186.58	Professional		$70.39	$79.12	$186.58
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $150.65 / $150.65 / $150.65	Facility		$150.65	$150.65	$150.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $119.01 / $150.65 / $150.65	Professional		$119.01	$150.65	$150.65