Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.00 / $102.00 / $301.50	Facility		$67.00	$102.00	$301.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $121.50 / $121.50	Facility		$100.00	$121.50	$121.50
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $110.00 / $110.00	Facility		$110.00	$110.00	$110.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $18,170.00 / $40,290.00	Facility		$49.00	$18,170.00	$40,290.00