Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $131.83	Professional		$107.15	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $151.36 / $151.36	Professional		$134.90	$151.36	$151.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $181.97 / $208.93	Professional		$154.88	$181.97	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $218.78	Facility		$131.83	$131.83	$218.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $151.36	Professional		$128.82	$134.90	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Midlands Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $151.36	Professional		$134.90	$134.90	$151.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97