Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $218.78 / $316.23	Facility		$87.10	$218.78	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $114.82	Professional		$75.86	$91.20	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $275.42	Professional		$218.78	$218.78	$275.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $208.93	Professional		$97.72	$151.36	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $138.04 / $263.03	Facility		$114.82	$138.04	$263.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $114.82 / $446.68	Professional		$69.18	$114.82	$446.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $263.03	Facility		$114.82	$114.82	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $288.40	Professional		$69.18	$69.18	$288.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82