Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $281.84	Facility	26	$45.71	$45.71	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $309.03	Professional		$100.00	$117.49	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $173.78 / $181.97	Facility	26	$169.82	$173.78	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $281.84 / $478.63	Professional		$162.18	$281.84	$478.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $204.17 / $724.44	Professional		$109.65	$204.17	$724.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $85.11 / $269.15	Professional	26	$48.98	$85.11	$269.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $245.47 / $245.47	Facility	26	$173.78	$245.47	$245.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $263.03 / $3,090.30	Professional		$134.90	$263.03	$3,090.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $302.00 / $616.60	Professional		$112.20	$302.00	$616.60
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $125.89 / $162.18	Professional	26	$104.71	$125.89	$162.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $281.84 / $616.60	Professional		$269.15	$281.84	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $181.97 / $407.38	Professional		$123.03	$181.97	$407.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $239.88	Professional		$204.17	$204.17	$239.88