Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $281.84	Facility	26	$46.77	$46.77	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $120.23 / $257.04	Professional		$102.33	$120.23	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $177.83 / $181.97	Facility	26	$173.78	$177.83	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $302.00 / $478.63	Professional		$169.82	$302.00	$478.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $213.80 / $741.31	Professional		$114.82	$213.80	$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 $177.83 / $245.47 / $245.47	Facility	26	$177.83	$245.47	$245.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $275.42 / $3,090.30	Professional		$144.54	$275.42	$3,090.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $602.56	Professional		$245.47	$323.59	$602.56
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $128.82 / $165.96	Professional	26	$104.71	$128.82	$165.96
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 $281.84 / $295.12 / $602.56	Professional		$281.84	$295.12	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $407.38	Professional		$128.82	$194.98	$407.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $257.04	Professional		$218.78	$218.78	$257.04