Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Facility		$19.05	$19.05	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $23.99	Professional		$19.05	$19.05	$23.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $23.99	Facility		$23.99	$23.99	$23.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $23.99 / $77.62	Professional		$17.38	$23.99	$77.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $26.30 / $28.18	Professional		$25.70	$26.30	$28.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $33.11 / $89.13	Facility		$19.50	$33.11	$89.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $67.61 / $77.62	Professional		$29.51	$67.61	$77.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Professional		$29.51	$29.51	$29.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $64.57	Professional		$51.29	$64.57	$64.57