Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.45 / $126.17 / $126.17	Facility		$85.45	$126.17	$126.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.93 / $73.56 / $102.84	Professional		$48.93	$73.56	$102.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.44 / $97.44 / $131.68	Facility		$97.44	$97.44	$131.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $174.75 / $218.44	Professional		$97.44	$174.75	$218.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $116.08 / $150.63 / $177.00	Professional		$116.08	$150.63	$177.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.34 / $156.60 / $629.92	Facility		$76.34	$156.60	$629.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $78.13 / $163.55	Professional		$58.60	$78.13	$163.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $131.29 / $131.68 / $178.42	Facility		$131.29	$131.68	$178.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.82 / $155.62 / $251.61	Professional		$107.82	$155.62	$251.61
United Facility/Professional Facility Modifier Low / Median / High Price $187.92 / $187.92 / $305.37	Facility		$187.92	$187.92	$305.37
United Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $67.72 / $156.88	Professional		$58.60	$67.72	$156.88
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $117.32 / $117.32 / $117.32	Facility		$117.32	$117.32	$117.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $92.68 / $117.32 / $117.32	Professional		$92.68	$117.32	$117.32