Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $269.15 / $398.11	Facility		$109.65	$269.15	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $114.82 / $141.25	Professional		$100.00	$114.82	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $338.84	Professional		$275.42	$275.42	$338.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $186.21 / $257.04	Professional		$120.23	$186.21	$257.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $169.82 / $331.13	Facility		$141.25	$169.82	$331.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $575.44	Professional		$85.11	$141.25	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $331.13	Facility		$141.25	$141.25	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $363.08	Professional		$85.11	$85.11	$363.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25