Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.20 / $222.20 / $409.32	Facility	26	$101.20	$222.20	$409.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.00 / $100.00 / $415.28	Professional	26	$87.00	$100.00	$415.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.73 / $224.26 / $230.79	Facility	26	$217.73	$224.26	$230.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $145.18 / $156.69 / $195.86	Professional	26	$145.18	$156.69	$195.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.90 / $118.03 / $201.47	Professional	26	$63.90	$118.03	$201.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $224.26 / $224.26 / $224.26	Facility	26	$224.26	$224.26	$224.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.97 / $81.20 / $289.02	Professional	26	$66.97	$81.20	$289.02
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $224.26 / $230.79 / $382.98	Facility	26	$224.26	$230.79	$382.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.97 / $81.20 / $157.81	Professional	26	$66.97	$81.20	$157.81
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $103.41 / $130.90 / $154.00	Professional	26	$103.41	$130.90	$154.00