Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.00 / $152.00 / $161.50	Professional		$152.00	$152.00	$161.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.73 / $148.41 / $174.99	Professional		$118.73	$148.41	$174.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $99.14 / $169.49 / $216.94	Professional		$99.14	$169.49	$216.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $152.00 / $190.00 / $256.88	Facility		$152.00	$190.00	$256.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.51 / $167.51 / $335.02	Professional		$167.51	$167.51	$335.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $82.86 / $174.99 / $204.27	Facility		$82.86	$174.99	$204.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $82.86 / $155.66 / $204.27	Professional		$82.86	$155.66	$204.27
United Facility/Professional Professional Modifier Low / Median / High Price $167.51 / $167.51 / $184.71	Professional		$167.51	$167.51	$184.71
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $162.60 / $162.60 / $162.60	Facility		$162.60	$162.60	$162.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $128.44 / $162.60 / $162.60	Professional		$128.44	$162.60	$162.60