Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $194.98	Facility		$141.25	$141.25	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $151.36	Professional		$74.13	$114.82	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $204.17	Facility		$112.20	$112.20	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $269.15 / $338.84	Professional		$112.20	$269.15	$338.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $234.42	Professional		$173.78	$223.87	$234.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $234.42 / $912.01	Facility		$123.03	$234.42	$912.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $338.84	Professional		$87.10	$131.83	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $208.93 / $269.15	Professional		$199.53	$208.93	$269.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $302.00	Professional		$199.53	$302.00	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $134.90 / $288.40	Facility		$75.86	$134.90	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $97.72 / $173.78	Professional		$87.10	$97.72	$173.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $177.83	Professional		$141.25	$177.83	$177.83