Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $67.61	Facility		$57.54	$57.54	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $79.43	Professional		$38.02	$48.98	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $102.33	Facility		$57.54	$57.54	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $107.15 / $131.83	Professional		$57.54	$107.15	$131.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $91.20	Professional		$77.62	$87.10	$91.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $117.49 / $426.58	Facility		$58.88	$117.49	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $151.36	Professional		$40.74	$56.23	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $125.89	Professional		$100.00	$104.71	$125.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $151.36 / $151.36	Professional		$93.33	$151.36	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $67.61 / $134.90	Facility		$31.62	$67.61	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $45.71 / $83.18	Professional		$40.74	$45.71	$83.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $87.10	Professional		$69.18	$87.10	$87.10