Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $218.78	Facility		$194.98	$194.98	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $138.04 / $213.80	Professional		$104.71	$138.04	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $281.84	Facility		$186.21	$186.21	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $302.00 / $380.19	Professional		$186.21	$302.00	$380.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $269.15 / $316.23	Professional		$234.42	$269.15	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $323.59 / $1,288.25	Facility		$173.78	$323.59	$1,288.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $181.97 / $416.87	Professional		$120.23	$181.97	$416.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $288.40 / $371.54	Professional		$275.42	$288.40	$371.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $416.87 / $416.87	Professional		$281.84	$416.87	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $186.21 / $398.11	Facility		$120.23	$186.21	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $134.90 / $229.09	Professional		$120.23	$134.90	$229.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $245.47	Professional		$194.98	$245.47	$245.47