Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.39 / $94.05 / $94.05	Facility		$76.39	$94.05	$94.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $57.87 / $84.37	Professional		$40.14	$57.87	$84.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.21 / $60.21 / $105.99	Facility		$60.21	$60.21	$105.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.21 / $130.13 / $162.66	Professional		$60.21	$130.13	$162.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.45 / $112.28 / $126.26	Professional		$93.45	$112.28	$126.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.45 / $127.02 / $510.07	Facility		$61.45	$127.02	$510.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.64 / $64.09 / $131.63	Professional		$47.64	$64.09	$131.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $105.68 / $105.99 / $146.36	Facility		$105.68	$105.99	$146.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.50 / $125.26 / $202.55	Professional		$89.50	$125.26	$202.55
United Facility/Professional Professional Modifier Low / Median / High Price $47.64 / $54.26 / $113.44	Professional		$47.64	$54.26	$113.44
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $94.42 / $94.42 / $94.42	Facility		$94.42	$94.42	$94.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.59 / $94.42 / $94.42	Professional		$74.59	$94.42	$94.42