Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $330.00 / $330.00	Facility		$35.00	$330.00	$330.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $50.00 / $330.00	Professional		$35.00	$50.00	$330.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $371.70 / $416.25	Professional		$255.00	$371.70	$416.25
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $411.42 / $485.10 / $514.28	Professional	AA	$411.42	$485.10	$514.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,750.00 / $2,750.00 / $3,700.00	Facility		$2,750.00	$2,750.00	$3,700.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $110.00	Professional		$50.00	$65.00	$110.00
United Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.27 / $90.00	Professional		$50.00	$60.27	$90.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $304.20 / $384.00 / $399.00	Professional		$304.20	$384.00	$399.00
Wellmark Facility/Professional Professional Modifier AA Low / Median / High Price $444.00 / $444.00 / $444.00	Professional	AA	$444.00	$444.00	$444.00
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $199.50 / $222.00 / $246.00	Professional	QX	$199.50	$222.00	$246.00
Wellmark Facility/Professional Professional Modifier QZ Low / Median / High Price $346.20 / $346.20 / $346.20	Professional	QZ	$346.20	$346.20	$346.20