Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.74 / $190.00 / $190.00	Facility	26	$39.74	$190.00	$190.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.00 / $100.00 / $291.50	Professional	26	$87.00	$100.00	$291.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.76 / $88.33 / $90.91	Facility	26	$85.76	$88.33	$90.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.20 / $66.70 / $83.39	Professional	26	$61.20	$66.70	$83.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.65 / $44.35 / $728.39	Professional	26	$29.65	$44.35	$728.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $88.33 / $88.33 / $88.33	Facility	26	$88.33	$88.33	$88.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.74 / $35.02 / $107.63	Professional	26	$28.74	$35.02	$107.63
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $88.33 / $90.91 / $160.97	Facility	26	$88.33	$90.91	$160.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.74 / $35.02 / $59.00	Professional	26	$28.74	$35.02	$59.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $43.61 / $55.20 / $64.90	Professional	26	$43.61	$55.20	$64.90