Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $64.57	Professional		$38.02	$48.98	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $104.71	Professional		$50.12	$70.79	$104.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $524.81 / $794.33	Professional		$151.36	$524.81	$794.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $75.86 / $323.59	Facility		$43.65	$75.86	$323.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $478.63	Professional		$57.54	$97.72	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $100.00 / $141.25	Professional		$75.86	$100.00	$141.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $104.71 / $123.03	Professional		$91.20	$104.71	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $380.19 / $501.19	Facility		$218.78	$380.19	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $89.13 / $158.49	Professional		$57.54	$89.13	$158.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $141.25	Professional		$112.20	$141.25	$141.25