Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $144.00 / $153.00	Professional		$144.00	$144.00	$153.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $216.18 / $216.18	Professional		$153.00	$216.18	$216.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $465.93 / $644.52	Professional		$150.00	$465.93	$644.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $180.00 / $244.80	Facility		$144.00	$180.00	$244.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $180.00 / $360.00	Professional		$180.00	$180.00	$360.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $216.18 / $216.18 / $216.18	Facility		$216.18	$216.18	$216.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $216.18 / $216.18 / $216.18	Professional		$216.18	$216.18	$216.18
United Facility/Professional Facility Modifier Low / Median / High Price $297.00 / $297.00 / $297.00	Facility		$297.00	$297.00	$297.00
United Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $180.00 / $198.00	Professional		$180.00	$180.00	$198.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $180.00 / $180.00	Facility		$180.00	$180.00	$180.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $142.19 / $180.00 / $180.00	Professional		$142.19	$180.00	$180.00