Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $177.83 / $229.09	Facility		$162.18	$177.83	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $194.98	Professional		$95.50	$134.90	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $257.04	Facility		$194.98	$194.98	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $316.23 / $398.11	Professional		$194.98	$316.23	$398.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $275.42	Professional		$213.80	$257.04	$275.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $295.12 / $1,174.90	Facility		$154.88	$295.12	$1,174.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $398.11	Professional		$112.20	$165.96	$398.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $257.04 / $338.84	Professional		$251.19	$257.04	$338.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $380.19	Professional		$257.04	$380.19	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $173.78 / $371.54	Facility		$112.20	$173.78	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $123.03 / $213.80	Professional		$112.20	$123.03	$213.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $223.87	Professional		$173.78	$223.87	$223.87