Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $85.11	Facility		$77.62	$77.62	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $104.71	Professional		$51.29	$64.57	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $138.04	Facility		$74.13	$74.13	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $141.25 / $177.83	Professional		$74.13	$141.25	$177.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $151.36	Professional		$104.71	$141.25	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $154.88 / $616.60	Facility		$85.11	$154.88	$616.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $208.93	Professional		$57.54	$77.62	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $141.25 / $177.83	Professional		$134.90	$141.25	$177.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $208.93 / $208.93	Professional		$134.90	$208.93	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $79.43 / $190.55	Facility		$44.67	$79.43	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $61.66 / $114.82	Professional		$57.54	$61.66	$114.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $117.49	Professional		$93.33	$117.49	$117.49