Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $407.38	Facility	26	$79.43	$79.43	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $758.58	Professional		$295.12	$426.58	$758.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $245.47 / $251.19	Facility	26	$239.88	$245.47	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $776.25 / $1,023.29	Professional		$436.52	$776.25	$1,023.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $1,659.59	Professional		$281.84	$478.63	$1,659.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $102.33 / $331.13	Professional	26	$70.79	$102.33	$331.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $549.54 / $707.95 / $707.95	Facility	26	$549.54	$707.95	$707.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $645.65 / $3,019.95	Professional		$416.87	$645.65	$3,019.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $812.83 / $1,023.29	Professional		$616.60	$812.83	$1,023.29
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $173.78 / $229.09	Professional	26	$151.36	$173.78	$229.09
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	26	$251.19	$251.19	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $1,023.29	Professional		$758.58	$758.58	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $1,096.48	Professional		$371.54	$524.81	$1,096.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $831.76	Professional		$707.95	$707.95	$831.76