Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $67.61 / $75.86	Facility		$64.57	$67.61	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $75.86	Professional		$37.15	$43.65	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $95.50	Facility		$48.98	$48.98	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $91.20 / $112.20	Professional		$48.98	$91.20	$112.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $117.49	Professional		$75.86	$97.72	$117.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $109.65 / $407.38	Facility		$58.88	$109.65	$407.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $144.54	Professional		$40.74	$58.88	$144.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $117.49	Professional		$93.33	$97.72	$117.49
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $144.54	Professional		$89.13	$144.54	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $60.26 / $125.89	Facility		$32.36	$60.26	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $44.67 / $77.62	Professional		$38.90	$44.67	$77.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $85.11	Professional		$66.07	$85.11	$85.11