Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.74 / $146.74 / $192.67	Professional		$146.74	$146.74	$192.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.49 / $496.01 / $496.01	Professional		$436.49	$496.01	$496.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $652.54 / $801.13 / $1,000.62	Professional		$652.54	$801.13	$1,000.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $146.74 / $216.15 / $528.66	Facility		$146.74	$216.15	$528.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $422.40 / $438.23 / $496.01	Professional		$422.40	$438.23	$496.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $482.58 / $496.01 / $496.01	Facility		$482.58	$496.01	$496.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $422.40 / $469.58 / $496.01	Professional		$422.40	$469.58	$496.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $84.17 / $84.17	Professional		$66.48	$84.17	$84.17