Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $186.21	Facility	26	$30.90	$30.90	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $234.42 / $537.03	Professional		$177.83	$234.42	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $109.65 / $114.82	Facility	26	$107.15	$109.65	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $512.86 / $645.65	Professional		$489.78	$512.86	$645.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $1,000.00	Professional		$186.21	$288.40	$1,000.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $57.54 / $120.23	Professional	26	$35.48	$57.54	$120.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $154.88	Facility	26	$109.65	$109.65	$154.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $346.74 / $724.44	Professional		$190.55	$346.74	$724.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $457.09 / $616.60	Professional		$416.87	$457.09	$616.60
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $79.43 / $134.90	Professional	26	$69.18	$79.43	$134.90
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	26	$114.82	$114.82	$114.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $549.54	Professional		$501.19	$501.19	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $257.04 / $537.03	Professional		$186.21	$257.04	$537.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $363.08 / $426.58	Professional		$288.40	$363.08	$426.58