Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Facility		$64.57	$64.57	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $89.13	Professional		$41.69	$54.95	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $114.82	Facility		$57.54	$57.54	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $120.23 / $147.91	Professional		$57.54	$120.23	$147.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $128.82	Professional		$87.10	$117.49	$128.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $131.83 / $478.63	Facility		$64.57	$131.83	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $63.10 / $169.82	Professional		$45.71	$63.10	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $138.04	Professional		$112.20	$117.49	$138.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $169.82	Professional		$104.71	$169.82	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $75.86 / $151.36	Facility		$35.48	$75.86	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $51.29 / $93.33	Professional		$45.71	$51.29	$93.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $97.72	Professional		$75.86	$97.72	$97.72