Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $26.92 / $38.02	Facility	26	$25.12	$26.92	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $257.04	Professional		$67.61	$104.71	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $95.50 / $97.72	Facility	26	$91.20	$95.50	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $245.47 / $309.03	Professional		$131.83	$245.47	$309.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $295.12	Professional		$89.13	$141.25	$295.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $83.18	Professional	26	$27.54	$40.74	$83.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $125.89 / $125.89	Facility	26	$95.50	$125.89	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $123.03 / $676.08	Professional		$64.57	$123.03	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $218.78 / $263.03	Professional		$131.83	$218.78	$263.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $67.61 / $74.13	Professional	26	$57.54	$67.61	$74.13
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Facility	26	$97.72	$97.72	$97.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $263.03	Professional		$181.97	$181.97	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $104.71 / $190.55	Professional		$58.88	$104.71	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $204.17	Professional		$128.82	$173.78	$204.17