Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $275.42	Facility	26	$30.90	$30.90	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $57.54 / $112.20	Professional		$45.71	$57.54	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $33.88 / $75.86	Professional	26	$28.18	$33.88	$75.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	50	$144.54	$144.54	$144.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $162.18 / $165.96	Facility	26	$154.88	$162.18	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $181.97	Professional		$91.20	$134.90	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $83.18 / $107.15	Professional	26	$45.71	$83.18	$107.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $177.83 / $234.42	Professional		$56.23	$177.83	$234.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $87.10 / $134.90	Professional	26	$34.67	$87.10	$134.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $199.53 / $199.53	Facility	26	$162.18	$199.53	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $120.23 / $691.83	Professional		$64.57	$120.23	$691.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $53.70 / $302.00	Professional	26	$37.15	$53.70	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $213.80	Professional		$112.20	$144.54	$213.80
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $85.11 / $107.15	Professional	26	$70.79	$85.11	$107.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	26	$165.96	$165.96	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $213.80	Professional		$128.82	$151.36	$213.80
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $107.15	Professional	26	$79.43	$93.33	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $154.88	Professional		$61.66	$91.20	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $47.86 / $91.20	Professional	26	$37.15	$47.86	$91.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $117.49	Professional		$100.00	$100.00	$117.49
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $72.44	Professional	26	$61.66	$61.66	$72.44