Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $446.68 / $446.68	Facility		$162.18	$446.68	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $446.68	Professional		$162.18	$162.18	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $245.47 / $302.00	Facility		$190.55	$245.47	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $173.78 / $213.80	Professional		$162.18	$173.78	$213.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $275.42	Professional		$138.04	$162.18	$275.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $213.80 / $446.68	Facility		$165.96	$213.80	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $407.38	Professional		$165.96	$165.96	$407.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $446.68	Professional		$199.53	$263.03	$446.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $257.04 / $302.00	Facility		$204.17	$257.04	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $0.17 / $169.82 / $281.84	Facility		$0.17	$169.82	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $371.54	Professional		$125.89	$169.82	$371.54
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18