Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.43 / $121.43 / $268.41	Facility		$121.43	$121.43	$268.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $97.14 / $121.43	Professional		$97.14	$97.14	$121.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.50 / $20.63 / $20.63	Professional		$16.50	$20.63	$20.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Professional		$150.00	$150.00	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.43 / $33.02 / $121.43	Facility		$17.43	$33.02	$121.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.73 / $101.19 / $104.23	Professional		$17.73	$101.19	$104.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $17.89 / $24.46 / $264.45	Facility		$17.89	$24.46	$264.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $20.87 / $35.97	Professional		$16.00	$20.87	$35.97
United Facility/Professional Professional Modifier Low / Median / High Price $101.19 / $101.19 / $107.35	Professional		$101.19	$101.19	$107.35
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $101.19 / $101.19 / $101.19	Facility		$101.19	$101.19	$101.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $101.19 / $101.19 / $101.19	Professional		$101.19	$101.19	$101.19