Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.04 / $111.04 / $111.04	Facility		$111.04	$111.04	$111.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.04 / $111.04 / $127.14	Professional		$111.04	$111.04	$127.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.00 / $169.00 / $169.00	Facility		$169.00	$169.00	$169.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.53 / $216.18 / $216.18	Professional		$190.53	$216.18	$216.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $166.08 / $200.00 / $220.96	Professional		$166.08	$200.00	$220.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $111.04 / $144.35 / $248.48	Facility		$111.04	$144.35	$248.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $183.64 / $204.16 / $216.18	Professional		$183.64	$204.16	$216.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $216.18 / $216.18 / $216.18	Facility		$216.18	$216.18	$216.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.53 / $204.16 / $216.18	Professional		$190.53	$204.16	$216.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $55.34 / $70.05 / $70.05	Professional		$55.34	$70.05	$70.05