Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.96 / $190.00 / $190.00	Facility	26	$117.96	$190.00	$190.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.00 / $100.00 / $444.40	Professional	26	$87.00	$100.00	$444.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $255.29 / $262.95 / $270.61	Facility	26	$255.29	$262.95	$270.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $184.32 / $200.13 / $250.16	Professional	26	$184.32	$200.13	$250.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.46 / $133.82 / $4,351.52	Professional	26	$89.46	$133.82	$4,351.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $262.95 / $262.95 / $262.95	Facility	26	$262.95	$262.95	$262.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $85.37 / $104.26 / $320.42	Professional	26	$85.37	$104.26	$320.42
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $262.95 / $270.61 / $488.58	Facility	26	$262.95	$270.61	$488.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.37 / $99.84 / $175.13	Professional	26	$85.37	$99.84	$175.13
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $131.30 / $166.20 / $195.50	Professional	26	$131.30	$166.20	$195.50