Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $154.88	Facility		$131.83	$131.83	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $181.97	Professional		$87.10	$112.20	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $234.42	Facility		$147.91	$147.91	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $245.47 / $302.00	Professional		$147.91	$245.47	$302.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $269.15	Professional		$177.83	$251.19	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $245.47 / $977.24	Facility		$141.25	$245.47	$977.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $346.74	Professional		$93.33	$128.82	$346.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $239.88 / $281.84	Professional		$229.09	$239.88	$281.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $346.74 / $346.74	Professional		$213.80	$346.74	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $154.88 / $309.03	Facility		$72.44	$154.88	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $104.71 / $190.55	Professional		$93.33	$104.71	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $199.53	Professional		$158.49	$199.53	$199.53