Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $90.64	Professional		$89.75	$89.75	$90.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.16 / $91.45 / $171.26	Professional		$73.16	$91.45	$171.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $71.80 / $89.75 / $162.44	Professional		$71.80	$89.75	$162.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $126.91 / $1,668.00	Facility		$82.41	$126.91	$1,668.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.41 / $82.41 / $239.19	Professional		$82.41	$82.41	$239.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $83.70 / $86.18 / $110.13	Facility		$83.70	$86.18	$110.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.70 / $95.45 / $239.19	Professional		$83.70	$95.45	$239.19
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $96.93	Professional		$89.75	$89.75	$96.93
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $82.41 / $82.41	Facility		$82.41	$82.41	$82.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $65.09 / $82.41 / $82.41	Professional		$65.09	$82.41	$82.41