Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.61 / $110.82 / $205.01	Facility	26	$69.61	$110.82	$205.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.77 / $205.25 / $460.00	Professional		$190.77	$205.25	$460.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.21 / $110.43 / $113.64	Facility	26	$107.21	$110.43	$113.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $454.72 / $501.88 / $627.35	Professional		$454.72	$501.88	$627.35
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $184.31 / $287.75 / $793.69	Professional		$184.31	$287.75	$793.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.21 / $52.65 / $121.11	Professional	26	$32.21	$52.65	$121.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $110.43 / $110.43 / $110.43	Facility	26	$110.43	$110.43	$110.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $207.68 / $307.00 / $723.42	Professional		$207.68	$307.00	$723.42
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $110.43 / $113.64 / $191.04	Facility	26	$110.43	$113.64	$191.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $307.00 / $454.72 / $595.24	Professional		$307.00	$454.72	$595.24
United Facility/Professional Professional Modifier Low / Median / High Price $207.68 / $256.50 / $449.48	Professional		$207.68	$256.50	$449.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $288.19 / $364.80 / $429.20	Professional		$288.19	$364.80	$429.20