Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $954.99	Facility		$173.78	$173.78	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $173.78 / $173.78	Professional		$144.54	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $173.78	Professional		$141.25	$141.25	$173.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $549.54 / $676.08	Professional		$151.36	$549.54	$676.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $181.97 / $338.84	Facility		$131.83	$181.97	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $123.03	Professional		$104.71	$114.82	$123.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $123.03	Professional		$107.15	$107.15	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $354.81 / $467.74	Facility		$204.17	$354.81	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $165.96	Professional		$144.54	$144.54	$165.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $125.89	Professional		$100.00	$125.89	$125.89