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 $95.50 / $117.49 / $295.12	Professional		$95.50	$117.49	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $173.78 / $177.83	Facility	26	$169.82	$173.78	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $269.15 / $457.09	Professional		$151.36	$269.15	$457.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $194.98 / $741.31	Professional		$102.33	$194.98	$741.31
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $85.11 / $295.12	Professional	26	$50.12	$85.11	$295.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $239.88 / $239.88	Facility	26	$173.78	$239.88	$239.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $3,388.44	Professional		$131.83	$257.04	$3,388.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $588.84	Professional		$223.87	$288.40	$588.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $125.89 / $162.18	Professional	26	$102.33	$125.89	$162.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $269.15 / $588.84	Professional		$263.03	$269.15	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $398.11	Professional		$117.49	$177.83	$398.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $229.09	Professional		$194.98	$194.98	$229.09