Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $33.88 / $457.09	Facility	26	$33.88	$33.88	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $213.80	Professional		$57.54	$75.86	$213.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $575.44 / $575.44 / $575.44	Professional	50	$575.44	$575.44	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $302.00 / $309.03 / $316.23	Facility	26	$302.00	$309.03	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $251.19	Professional		$131.83	$181.97	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $269.15 / $467.74	Professional		$63.10	$269.15	$467.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $162.18 / $229.09	Professional	26	$36.31	$162.18	$229.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $309.03 / $331.13 / $331.13	Facility	26	$309.03	$331.13	$331.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $165.96 / $891.25	Professional		$93.33	$165.96	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $186.21 / $323.59	Professional		$134.90	$186.21	$323.59
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $102.33 / $177.83	Professional	26	$77.62	$102.33	$177.83
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	26	$316.23	$316.23	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $194.98 / $363.08	Professional		$158.49	$194.98	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $134.90 / $239.88	Professional		$89.13	$134.90	$239.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $141.25	Professional		$120.23	$120.23	$141.25