Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.13 / $57.13 / $57.13	Facility		$57.13	$57.13	$57.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $47.42 / $57.13	Professional		$45.70	$47.42	$57.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $151.50 / $190.50	Professional		$61.75	$151.50	$190.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $275.00	Professional		$150.00	$150.00	$275.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.59 / $57.13 / $202.47	Facility		$18.59	$57.13	$202.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $548.62 / $1,576.28 / $1,945.13	Professional		$548.62	$1,576.28	$1,945.13
Midlands Facility/Professional Facility Modifier Low / Median / High Price $169.51 / $181.09 / $227.01	Facility		$169.51	$181.09	$227.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $181.09 / $227.01	Professional		$61.75	$181.09	$227.01
United Facility/Professional Professional Modifier Low / Median / High Price $57.13 / $57.13 / $72.56	Professional		$57.13	$57.13	$72.56
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,575.00 / $1,575.00 / $1,575.00	Facility		$1,575.00	$1,575.00	$1,575.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,244.25 / $1,575.00 / $1,575.00	Professional		$1,244.25	$1,575.00	$1,575.00