Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,069.90 / $1,069.90 / $1,069.90	Facility		$1,069.90	$1,069.90	$1,069.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $876.00 / $876.00 / $876.00	Professional		$876.00	$876.00	$876.00
United Facility/Professional Facility Modifier Low / Median / High Price $29.87 / $77.95 / $117.76	Facility		$29.87	$77.95	$117.76