Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.06 / $196.11 / $196.11	Facility		$160.06	$196.11	$196.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.15 / $114.32 / $153.76	Professional		$73.15	$114.32	$153.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $113.00 / $199.13	Facility		$113.00	$113.00	$199.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.00 / $271.50 / $339.38	Professional		$113.00	$271.50	$339.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $175.60 / $222.80 / $236.00	Professional		$175.60	$222.80	$236.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $115.45 / $235.34 / $917.84	Facility		$115.45	$235.34	$917.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.61 / $116.81 / $247.35	Professional		$87.61	$116.81	$247.35
Midlands Facility/Professional Facility Modifier Low / Median / High Price $198.55 / $199.13 / $266.75	Facility		$198.55	$199.13	$266.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.00 / $232.62 / $380.56	Professional		$177.00	$232.62	$380.56
United Facility/Professional Professional Modifier Low / Median / High Price $87.61 / $102.83 / $237.27	Professional		$87.61	$102.83	$237.27
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $177.41 / $177.41 / $177.41	Facility		$177.41	$177.41	$177.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $140.15 / $177.41 / $177.41	Professional		$140.15	$177.41	$177.41