Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $134.90	Professional		$79.43	$79.43	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $154.88	Professional		$123.03	$123.03	$154.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $134.90 / $218.78	Facility		$112.20	$134.90	$218.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $213.80	Professional		$165.96	$213.80	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $213.80 / $251.19	Professional		$194.98	$213.80	$251.19
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03