Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $117.49	Facility		$97.72	$97.72	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $83.18 / $134.90	Professional		$67.61	$83.18	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $147.91	Facility		$89.13	$89.13	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $194.98	Professional		$89.13	$147.91	$194.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $15.49 / $32.36	Professional		$15.49	$15.49	$32.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $30.20 / $251.19	Facility		$20.42	$30.20	$251.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $25.70 / $162.18	Professional		$8.13	$25.70	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $7.76 / $15.49 / $123.03	Facility		$7.76	$15.49	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $64.57 / $151.36	Professional		$8.13	$64.57	$151.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $177.83	Professional		$141.25	$177.83	$177.83