Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Facility		$323.59	$323.59	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $363.08	Professional		$251.19	$323.59	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $44.67	Professional		$38.90	$38.90	$44.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $691.83 / $870.96	Professional		$151.36	$691.83	$870.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $323.59 / $524.81	Facility		$47.86	$323.59	$524.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $41.69 / $281.84	Professional		$38.02	$41.69	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Professional		$44.67	$44.67	$44.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $44.67	Professional		$38.90	$38.90	$44.67
United Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $371.54 / $489.78	Facility		$213.80	$371.54	$489.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $173.78 / $173.78	Professional		$134.90	$173.78	$173.78