Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $180.00 / $180.00	Facility		$180.00	$180.00	$180.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $180.00	Professional		$65.88	$65.88	$180.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $82.12 / $180.15	Professional		$65.95	$82.12	$180.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $119.24	Professional		$65.88	$65.88	$119.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.34 / $180.00 / $252.46	Facility		$66.34	$180.00	$252.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $66.34 / $180.15	Professional		$66.34	$66.34	$180.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $73.01 / $77.70 / $96.07	Facility		$73.01	$77.70	$96.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $79.62 / $180.15	Professional		$77.70	$79.62	$180.15
United Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $114.72	Professional		$65.88	$65.88	$114.72
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $66.34 / $66.34 / $66.34	Facility		$66.34	$66.34	$66.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $52.42 / $66.34 / $66.34	Professional		$52.42	$66.34	$66.34