Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $115.00 / $115.00	Facility		$115.00	$115.00	$115.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $50.72 / $115.00	Professional		$50.72	$50.72	$115.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.14 / $65.55 / $69.56	Professional		$52.14	$65.55	$69.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.58 / $56.02 / $91.80	Professional		$40.58	$56.02	$91.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.41 / $69.33 / $135.56	Facility		$45.41	$69.33	$135.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $45.41 / $90.82	Professional		$45.41	$45.41	$90.82
Midlands Facility/Professional Facility Modifier Low / Median / High Price $54.49 / $65.55 / $78.08	Facility		$54.49	$65.55	$78.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $65.55 / $78.08	Professional		$53.38	$65.55	$78.08
United Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $50.72 / $65.98	Professional		$50.72	$50.72	$65.98
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $45.41 / $45.41 / $45.41	Facility		$45.41	$45.41	$45.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $45.41 / $45.41	Professional		$35.86	$45.41	$45.41