Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.09 / $133.58 / $133.58	Facility		$120.09	$133.58	$133.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.44 / $95.79 / $139.65	Professional		$66.44	$95.79	$139.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.66 / $99.66 / $210.39	Facility		$99.66	$99.66	$210.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.66 / $184.88 / $231.09	Professional		$99.66	$184.88	$231.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $159.47 / $193.90 / $237.60	Professional		$159.47	$193.90	$237.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $121.97 / $245.77 / $840.48	Facility		$121.97	$245.77	$840.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.81 / $111.14 / $250.66	Professional		$89.81	$111.14	$250.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $209.79 / $210.39 / $252.15	Facility		$209.79	$210.39	$252.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.48 / $242.28 / $402.04	Professional		$169.48	$242.28	$402.04
United Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $95.42 / $207.32	Professional		$91.16	$95.42	$207.32
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $187.43 / $187.43 / $187.43	Facility		$187.43	$187.43	$187.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $148.07 / $187.43 / $187.43	Professional		$148.07	$187.43	$187.43