Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.03 / $85.03 / $166.47	Professional		$85.03	$85.03	$166.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $652.10 / $741.02 / $741.02	Professional		$652.10	$741.02	$741.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $213.45 / $262.05 / $327.30	Professional		$213.45	$262.05	$327.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $157.94 / $197.44 / $789.79	Facility		$157.94	$197.44	$789.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $631.91 / $655.59 / $741.02	Professional		$631.91	$655.59	$741.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $721.96 / $741.02 / $741.02	Facility		$721.96	$741.02	$741.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $631.91 / $702.51 / $741.02	Professional		$631.91	$702.51	$741.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $60.01 / $75.95 / $75.95	Professional		$60.01	$75.95	$75.95