Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.96 / $110.43 / $110.43	Facility		$96.96	$110.43	$110.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.23 / $70.73 / $111.44	Professional		$55.23	$70.73	$111.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.66 / $104.66 / $144.29	Facility		$104.66	$104.66	$144.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.66 / $153.00 / $191.25	Professional		$104.66	$153.00	$191.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.25 / $153.38 / $383.50	Professional		$125.25	$153.38	$383.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.65 / $170.52 / $613.91	Facility		$83.65	$170.52	$613.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.71 / $82.08 / $179.22	Professional		$62.71	$82.08	$179.22
Midlands Facility/Professional Facility Modifier Low / Median / High Price $143.87 / $144.29 / $178.92	Facility		$143.87	$144.29	$178.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $118.18 / $168.55 / $275.74	Professional		$118.18	$168.55	$275.74
United Facility/Professional Professional Modifier Low / Median / High Price $62.53 / $77.65 / $171.92	Professional		$62.53	$77.65	$171.92
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $128.55 / $128.55 / $128.55	Facility		$128.55	$128.55	$128.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $101.55 / $128.55 / $128.55	Professional		$101.55	$128.55	$128.55