Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.09 / $120.65 / $120.65	Facility		$91.09	$120.65	$120.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $75.19 / $132.44	Professional		$56.32	$75.19	$132.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.25 / $99.25 / $153.10	Facility		$99.25	$99.25	$153.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.69 / $166.88 / $208.59	Professional		$134.69	$166.88	$208.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $157.28 / $188.80	Professional		$135.00	$157.28	$188.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.76 / $180.93 / $682.16	Facility		$88.76	$180.93	$682.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.55 / $87.25 / $190.18	Professional		$66.55	$87.25	$190.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $152.66 / $153.10 / $190.19	Facility		$152.66	$153.10	$190.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.40 / $179.56 / $292.62	Professional		$125.40	$179.56	$292.62
United Facility/Professional Facility Modifier Low / Median / High Price $0.10 / $61.90 / $94.11	Facility		$0.10	$61.90	$94.11
United Facility/Professional Professional Modifier Low / Median / High Price $66.55 / $73.87 / $182.43	Professional		$66.55	$73.87	$182.43
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $136.40 / $136.40 / $136.40	Facility		$136.40	$136.40	$136.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.76 / $136.40 / $136.40	Professional		$107.76	$136.40	$136.40