Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $575.44	Professional		$112.20	$112.20	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $245.47 / $302.00	Facility		$190.55	$245.47	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $181.97 / $229.09	Professional		$112.20	$181.97	$229.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $478.63 / $977.24	Professional		$112.20	$478.63	$977.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $213.80 / $1,000.00	Facility		$128.82	$213.80	$1,000.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $741.31	Professional		$128.82	$128.82	$741.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $741.31	Professional		$154.88	$275.42	$741.31
Midlands Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $257.04 / $302.00	Facility		$204.17	$257.04	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Professional		$741.31	$741.31	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $0.18 / $177.83 / $295.12	Facility		$0.18	$177.83	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $812.83	Professional		$125.89	$177.83	$812.83
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20