Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.76 / $65.11 / $120.08	Facility	26	$33.76	$65.11	$120.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.08 / $154.08 / $1,309.08	Professional		$154.08	$154.08	$1,309.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.90 / $65.81 / $67.73	Facility	26	$63.90	$65.81	$67.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.60 / $413.45 / $516.80	Professional		$373.60	$413.45	$516.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.75 / $235.56 / $546.29	Professional		$150.75	$235.56	$546.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.79 / $30.79 / $61.19	Professional	26	$18.79	$30.79	$61.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $65.81 / $65.81 / $65.81	Facility	26	$65.81	$65.81	$65.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.54 / $233.07 / $540.04	Professional		$154.54	$233.07	$540.04
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $65.81 / $67.73 / $111.06	Facility	26	$65.81	$67.73	$111.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $228.43 / $373.60 / $521.66	Professional		$228.43	$373.60	$521.66
United Facility/Professional Professional Modifier Low / Median / High Price $163.13 / $196.88 / $361.58	Professional		$163.13	$196.88	$361.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $236.76 / $299.70 / $352.60	Professional		$236.76	$299.70	$352.60