Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $110.53	Professional		$109.44	$109.44	$110.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $262.97 / $457.16	Professional		$109.44	$262.97	$457.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $198.09 / $393.94	Professional		$109.44	$198.09	$393.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $130.11 / $344.69 / $1,668.00	Facility		$130.11	$344.69	$1,668.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.11 / $130.11 / $457.16	Professional		$130.11	$130.11	$457.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.74 / $247.78 / $397.72	Facility		$95.74	$247.78	$397.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $156.13 / $302.26 / $457.16	Professional		$156.13	$302.26	$457.16
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $142.38	Professional		$109.44	$109.44	$142.38
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $130.11 / $130.11 / $130.11	Facility		$130.11	$130.11	$130.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.79 / $130.11 / $130.11	Professional		$102.79	$130.11	$130.11