Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.45 / $85.45 / $107.05	Facility		$85.45	$85.45	$107.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $69.00 / $109.10	Professional		$56.98	$69.00	$109.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.08 / $139.08 / $139.08	Facility		$139.08	$139.08	$139.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.48 / $235.15 / $293.94	Professional		$164.48	$235.15	$293.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $407.60 / $419.20 / $448.40	Professional		$407.60	$419.20	$448.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.00 / $234.00 / $600.04	Facility		$69.00	$234.00	$600.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $86.54 / $260.29	Professional		$66.48	$86.54	$260.29
Midlands Facility/Professional Facility Modifier Low / Median / High Price $138.09 / $164.48 / $260.29	Facility		$138.09	$164.48	$260.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $137.41 / $208.16 / $282.97	Professional		$137.41	$208.16	$282.97
United Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $75.00 / $182.35	Professional		$66.48	$75.00	$182.35
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $216.88 / $216.88 / $216.88	Facility		$216.88	$216.88	$216.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $171.34 / $216.88 / $216.88	Professional		$171.34	$216.88	$216.88