Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $90.30	Professional		$89.41	$89.41	$90.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.79 / $113.33 / $270.23	Professional		$93.79	$113.33	$270.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $161.83 / $413.10	Professional		$89.41	$161.83	$413.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.11 / $143.38 / $235.35	Facility		$93.11	$143.38	$235.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $93.11 / $270.23	Professional		$93.11	$93.11	$270.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $99.38 / $111.73 / $130.76	Facility		$99.38	$111.73	$130.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $110.44 / $113.33 / $270.23	Professional		$110.44	$113.33	$270.23
United Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $155.69	Professional		$89.41	$89.41	$155.69
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $93.11 / $93.11 / $93.11	Facility		$93.11	$93.11	$93.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $93.11 / $93.11	Professional		$73.56	$93.11	$93.11