Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $281.20 / $377.25	Facility		$180.00	$281.20	$377.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $57.93 / $377.25	Professional		$43.50	$57.93	$377.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.00 / $300.00 / $362.80	Professional		$164.00	$300.00	$362.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $212.50 / $250.00 / $406.81	Professional		$212.50	$250.00	$406.81
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 / $1,126.40	Professional		$45.75	$60.00	$1,126.40
United Facility/Professional Professional Modifier Low / Median / High Price $45.75 / $53.00 / $82.40	Professional		$45.75	$53.00	$82.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $320.00 / $320.00 / $410.00	Professional		$320.00	$320.00	$410.00