Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $93.33	Facility		$79.43	$79.43	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $112.20	Professional		$52.48	$67.61	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $141.25	Facility		$70.79	$70.79	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $147.91 / $186.21	Professional		$70.79	$147.91	$186.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $134.90	Professional		$107.15	$125.89	$134.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $162.18 / $588.84	Facility		$79.43	$162.18	$588.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $213.80	Professional		$56.23	$77.62	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $144.54 / $173.78	Professional		$138.04	$144.54	$173.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $213.80 / $213.80	Professional		$131.83	$213.80	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $95.50 / $186.21	Facility		$43.65	$95.50	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $63.10 / $114.82	Professional		$56.23	$63.10	$114.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $120.23 / $120.23	Professional		$95.50	$120.23	$120.23