Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.00 / $449.92 / $603.60	Facility		$288.00	$449.92	$603.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $57.93 / $603.60	Professional		$43.50	$57.93	$603.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.00 / $525.00 / $634.90	Professional		$287.00	$525.00	$634.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $340.00 / $400.00 / $650.90	Professional		$340.00	$400.00	$650.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.93 / $89.21 / $4,055.10	Facility		$57.93	$89.21	$4,055.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.75 / $60.00 / $1,802.24	Professional		$45.75	$60.00	$1,802.24
United Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $56.65 / $82.40	Professional		$45.00	$56.65	$82.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $512.00 / $512.00 / $656.00	Professional		$512.00	$512.00	$656.00