Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $76.84	Professional		$76.09	$76.09	$76.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $109.97 / $204.48	Professional		$87.98	$109.97	$204.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $127.48 / $232.41	Professional		$76.09	$127.48	$232.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.23 / $133.90 / $350.93	Facility		$79.23	$133.90	$350.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $79.23 / $204.48	Professional		$79.23	$79.23	$204.48
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.07 / $103.62 / $143.32	Facility		$95.07	$103.62	$143.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $96.94 / $110.54 / $204.48	Professional		$96.94	$110.54	$204.48
United Facility/Professional Facility Modifier Low / Median / High Price $142.47 / $142.47 / $142.47	Facility		$142.47	$142.47	$142.47
United Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $85.03	Professional		$76.09	$76.09	$85.03
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $79.23 / $79.23 / $79.23	Facility		$79.23	$79.23	$79.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $62.59 / $79.23 / $79.23	Professional		$62.59	$79.23	$79.23