Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $229.09 / $263.03	Professional		$109.65	$229.09	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $275.42 / $346.74	Professional		$114.82	$275.42	$346.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $316.23 / $467.74	Professional		$213.80	$316.23	$467.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $281.84 / $457.09	Facility		$199.53	$281.84	$457.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $263.03	Professional		$100.00	$158.49	$263.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $616.60 / $616.60	Professional		$234.42	$616.60	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Facility		$323.59	$323.59	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $204.17	Professional		$100.00	$158.49	$204.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Professional		$1,479.11	$1,479.11	$1,479.11