Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $117.49	Facility	26	$100.00	$100.00	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $112.20 / $331.13	Professional	26	$83.18	$112.20	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $263.03 / $269.15	Facility	26	$257.04	$263.03	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $204.17 / $257.04	Professional	26	$199.53	$204.17	$257.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $134.90 / $5,495.41	Professional	26	$91.20	$134.90	$5,495.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $389.05	Facility	26	$263.03	$263.03	$389.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $102.33 / $323.59	Professional	26	$81.28	$102.33	$323.59
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $186.21 / $363.08	Professional	26	$158.49	$186.21	$363.08
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $204.17 / $234.42	Professional	26	$204.17	$204.17	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $104.71 / $229.09	Professional	26	$85.11	$104.71	$229.09
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $165.96 / $194.98	Professional	26	$131.83	$165.96	$194.98