Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $176.17 / $181.46	Facility		$158.91	$176.17	$181.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $184.34	Professional		$158.91	$158.91	$184.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.91 / $152.91 / $152.91	Facility		$152.91	$152.91	$152.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.58 / $178.52 / $189.47	Professional		$151.58	$178.52	$189.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $118.73 / $146.16 / $167.85	Professional		$118.73	$146.16	$167.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.26 / $192.71 / $654.50	Facility		$147.26	$192.71	$654.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $158.91 / $222.36	Professional		$63.57	$158.91	$222.36
Midlands Facility/Professional Facility Modifier Low / Median / High Price $151.91 / $178.52 / $197.98	Facility		$151.91	$178.52	$197.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $170.20 / $273.55	Professional		$92.00	$170.20	$273.55
United Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $158.91 / $245.58	Professional		$63.57	$158.91	$245.58
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $158.91 / $158.91	Facility		$158.91	$158.91	$158.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $158.91 / $173.91	Professional		$137.38	$158.91	$173.91