Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.97 / $142.11 / $262.82	Facility	26	$89.97	$142.11	$262.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.10 / $189.10 / $1,572.93	Professional		$189.10	$189.10	$1,572.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.16 / $142.32 / $146.46	Facility	26	$138.16	$142.32	$146.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $453.31 / $499.55 / $624.44	Professional		$453.31	$499.55	$624.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $184.62 / $319.29 / $606.38	Professional		$184.62	$319.29	$606.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.03 / $67.31 / $127.49	Professional	26	$41.03	$67.31	$127.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $142.32 / $142.32 / $142.32	Facility	26	$142.32	$142.32	$142.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $215.74 / $345.05 / $773.54	Professional		$215.74	$345.05	$773.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $142.32 / $146.46 / $245.04	Facility	26	$142.32	$146.46	$245.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $392.00 / $460.08 / $619.27	Professional		$392.00	$460.08	$619.27
United Facility/Professional Professional Modifier Low / Median / High Price $219.48 / $252.40 / $641.79	Professional		$219.48	$252.40	$641.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $287.32 / $363.70 / $427.90	Professional		$287.32	$363.70	$427.90