Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $134.90 / $501.19	Facility		$131.83	$134.90	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $134.90 / $275.42	Professional		$131.83	$134.90	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $169.82	Professional		$134.90	$154.88	$169.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $870.96	Professional		$131.83	$239.88	$870.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $389.05	Facility		$131.83	$131.83	$389.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $138.04 / $173.78	Professional		$114.82	$138.04	$173.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $177.83	Professional		$151.36	$151.36	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $138.04 / $158.49	Professional		$131.83	$138.04	$158.49
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83