Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.05 / $48.43 / $148.05	Facility	26	$26.05	$48.43	$148.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.12 / $92.16 / $183.63	Professional		$61.12	$92.16	$183.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.91 / $94.67 / $97.42	Facility	26	$91.91	$94.67	$97.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.81 / $241.24 / $301.55	Professional		$143.81	$241.24	$301.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.81 / $139.76 / $293.56	Professional		$89.81	$139.76	$293.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.25 / $40.40 / $82.50	Professional	26	$26.25	$40.40	$82.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $94.67 / $94.67 / $127.16	Facility	26	$94.67	$94.67	$127.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.27 / $123.20 / $681.03	Professional		$71.27	$123.20	$681.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $94.67 / $97.42 / $158.10	Facility	26	$94.67	$97.42	$158.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.02 / $205.41 / $265.42	Professional		$115.02	$205.41	$265.42
United Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $104.71 / $202.94	Professional		$73.56	$104.71	$202.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.09 / $174.80 / $205.60	Professional		$138.09	$174.80	$205.60