Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.96 / $102.64 / $189.57	Facility	26	$63.96	$102.64	$189.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.52 / $104.57 / $107.61	Facility	26	$101.52	$104.57	$107.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.41 / $48.23 / $73.48	Professional	26	$29.41	$48.23	$73.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $104.57 / $104.57 / $104.57	Facility	26	$104.57	$104.57	$104.57
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $104.57 / $107.61 / $175.02	Facility	26	$104.57	$107.61	$175.02