Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.50 / $73.19 / $135.34	Facility	26	$47.50	$73.19	$135.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.81 / $158.81 / $1,338.57	Professional		$158.81	$158.81	$1,338.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.53 / $74.70 / $76.88	Facility	26	$72.53	$74.70	$76.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $383.57 / $424.31 / $530.38	Professional		$383.57	$424.31	$530.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.91 / $241.97 / $440.43	Professional		$154.91	$241.97	$440.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $34.93 / $59.99	Professional	26	$21.26	$34.93	$59.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $74.70 / $74.70 / $74.70	Facility	26	$74.70	$74.70	$74.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $171.48 / $248.00 / $610.23	Professional		$171.48	$248.00	$610.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $74.70 / $76.88 / $126.30	Facility	26	$74.70	$76.88	$126.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $248.00 / $383.57 / $482.33	Professional		$248.00	$383.57	$482.33
United Facility/Professional Professional Modifier Low / Median / High Price $155.88 / $201.74 / $370.26	Professional		$155.88	$201.74	$370.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $243.08 / $307.70 / $362.00	Professional		$243.08	$307.70	$362.00