Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.64 / $126.32 / $126.32	Facility		$123.64	$126.32	$126.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $87.42 / $140.06	Professional		$65.00	$87.42	$140.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.54 / $97.54 / $171.83	Facility		$97.54	$97.54	$171.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.54 / $174.75 / $218.44	Professional		$97.54	$174.75	$218.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $148.40 / $166.25 / $199.57	Professional		$148.40	$166.25	$199.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.62 / $203.07 / $771.31	Facility		$99.62	$203.07	$771.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $99.79 / $213.42	Professional		$74.68	$99.79	$213.42
Midlands Facility/Professional Facility Modifier Low / Median / High Price $171.33 / $171.83 / $221.11	Facility		$171.33	$171.83	$221.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.85 / $200.72 / $328.35	Professional		$144.85	$200.72	$328.35
United Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $91.73 / $204.72	Professional		$74.68	$91.73	$204.72
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $153.09 / $153.09 / $153.09	Facility		$153.09	$153.09	$153.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.94 / $153.09 / $153.09	Professional		$120.94	$153.09	$153.09