Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.45 / $115.32 / $213.33	Facility	26	$79.45	$115.32	$213.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.88 / $151.88 / $1,254.35	Professional		$151.88	$151.88	$1,254.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.65 / $119.12 / $122.59	Facility	26	$115.65	$119.12	$122.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.34 / $401.81 / $502.27	Professional		$364.34	$401.81	$502.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $148.43 / $231.21 / $533.73	Professional		$148.43	$231.21	$533.73
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.49 / $55.03 / $113.45	Professional	26	$33.49	$55.03	$113.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $119.12 / $119.12 / $119.12	Facility	26	$119.12	$119.12	$119.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $175.06 / $233.00 / $579.64	Professional		$175.06	$233.00	$579.64
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $119.12 / $122.59 / $200.10	Facility	26	$119.12	$122.59	$200.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $233.00 / $363.36 / $447.70	Professional		$233.00	$363.36	$447.70
United Facility/Professional Professional Modifier Low / Median / High Price $175.06 / $192.57 / $351.33	Professional		$175.06	$192.57	$351.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $230.92 / $292.30 / $343.90	Professional		$230.92	$292.30	$343.90