Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $80.84	Professional		$80.04	$80.04	$80.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.56 / $101.95 / $749.21	Professional		$81.56	$101.95	$749.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $144.87	Professional		$80.04	$80.04	$144.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $589.00 / $811.64	Facility		$80.04	$589.00	$811.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $811.64	Professional		$80.04	$80.04	$811.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $96.05 / $123.26 / $936.51	Facility		$96.05	$123.26	$936.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $96.05 / $636.65 / $936.51	Professional		$96.05	$636.65	$936.51
United Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $104.13	Professional		$80.04	$80.04	$104.13
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Facility		$80.04	$80.04	$80.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.23 / $80.04 / $80.04	Professional		$63.23	$80.04	$80.04