Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.74 / $129.54 / $129.54	Facility		$113.74	$129.54	$129.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.76 / $82.96 / $130.68	Professional		$64.76	$82.96	$130.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.03 / $100.03 / $169.28	Facility		$100.03	$100.03	$169.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.03 / $179.25 / $224.06	Professional		$100.03	$179.25	$224.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $146.91 / $170.05 / $222.99	Professional		$146.91	$170.05	$222.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.13 / $200.06 / $720.06	Facility		$98.13	$200.06	$720.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $97.46 / $209.85	Professional		$73.56	$97.46	$209.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $168.78 / $169.28 / $209.85	Facility		$168.78	$169.28	$209.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.63 / $197.73 / $323.45	Professional		$138.63	$197.73	$323.45
United Facility/Professional Professional Modifier Low / Median / High Price $68.92 / $79.64 / $201.67	Professional		$68.92	$79.64	$201.67
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $150.81 / $150.81 / $150.81	Facility		$150.81	$150.81	$150.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $119.14 / $150.81 / $150.81	Professional		$119.14	$150.81	$150.81