Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $42.66 / $104.71	Facility		$26.92	$42.66	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $128.82 / $5,011.87	Professional		$26.92	$128.82	$5,011.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $27.54	Facility		$27.54	$27.54	$27.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $35.48	Professional		$28.18	$33.11	$35.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $83.18 / $169.82	Professional		$26.92	$83.18	$169.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $30.20 / $91.20	Facility		$25.12	$30.20	$91.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $54.95	Professional		$25.12	$25.12	$54.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $54.95	Professional		$33.88	$33.88	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $27.54	Facility		$27.54	$27.54	$27.54
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $28.84	Professional		$27.54	$27.54	$28.84
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $26.92	Facility		$26.92	$26.92	$26.92