Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.18 / $115.47 / $115.47	Facility		$88.18	$115.47	$115.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.45 / $72.79 / $115.47	Professional		$54.45	$72.79	$115.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.19 / $89.19 / $134.93	Facility		$89.19	$89.19	$134.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.19 / $159.75 / $199.69	Professional		$89.19	$159.75	$199.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $118.98 / $137.86 / $167.56	Professional		$118.98	$137.86	$167.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.22 / $159.77 / $645.28	Facility		$78.22	$159.77	$645.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.47 / $80.62 / $167.61	Professional		$60.47	$80.62	$167.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $134.54 / $134.93 / $184.13	Facility		$134.54	$134.93	$184.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $110.52 / $159.46 / $257.87	Professional		$110.52	$159.46	$257.87
United Facility/Professional Professional Modifier Low / Median / High Price $60.47 / $69.89 / $160.77	Professional		$60.47	$69.89	$160.77
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $120.21 / $120.21 / $120.21	Facility		$120.21	$120.21	$120.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.97 / $120.21 / $120.21	Professional		$94.97	$120.21	$120.21