Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $220.00 / $301.80	Facility		$144.00	$220.00	$301.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $57.93 / $299.36	Professional		$38.00	$57.93	$299.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $225.00 / $272.10	Professional		$123.00	$225.00	$272.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $200.00 / $325.45	Professional		$170.00	$200.00	$325.45
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 / $901.12	Professional		$45.75	$60.00	$901.12
United Facility/Professional Professional Modifier Low / Median / High Price $45.75 / $60.91 / $90.00	Professional		$45.75	$60.91	$90.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $256.00 / $256.00 / $328.00	Professional		$256.00	$256.00	$328.00