Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.53 / $102.53 / $108.55	Facility		$102.53	$102.53	$108.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.46 / $75.84 / $132.50	Professional		$61.46	$75.84	$132.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.71 / $83.71 / $161.52	Facility		$83.71	$83.71	$161.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.71 / $171.00 / $219.66	Professional		$83.71	$171.00	$219.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $140.18 / $163.04 / $176.16	Professional		$140.18	$163.04	$176.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $188.69 / $688.05	Facility		$75.00	$188.69	$688.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.92 / $77.56 / $200.63	Professional		$65.92	$77.56	$200.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $161.52 / $161.52 / $200.74	Facility		$161.52	$161.52	$200.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.02 / $190.89 / $308.68	Professional		$123.02	$190.89	$308.68
United Facility/Professional Facility Modifier Low / Median / High Price $54.45 / $65.33 / $78.41	Facility		$54.45	$65.33	$78.41
United Facility/Professional Professional Modifier Low / Median / High Price $65.92 / $73.26 / $139.77	Professional		$65.92	$73.26	$139.77
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $139.50 / $139.50 / $139.50	Facility		$139.50	$139.50	$139.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $110.21 / $139.50 / $139.50	Professional		$110.21	$139.50	$139.50