Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $53.00 / $53.53	Professional		$53.00	$53.00	$53.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.21 / $111.52 / $343.15	Professional		$89.21	$111.52	$343.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $95.93 / $239.27	Professional		$53.00	$95.93	$239.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $118.93 / $1,140.00	Facility		$53.00	$118.93	$1,140.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $53.00 / $407.03	Professional		$53.00	$53.00	$407.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $63.60 / $118.93 / $407.03	Facility		$63.60	$118.93	$407.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.74 / $118.93 / $211.04	Professional		$87.74	$118.93	$211.04
United Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $53.00 / $58.30	Professional		$53.00	$53.00	$58.30
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $53.00 / $53.00	Facility		$53.00	$53.00	$53.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $41.87 / $53.00 / $53.00	Professional		$41.87	$53.00	$53.00