Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $28.84 / $61.66	Facility	26	$26.92	$28.84	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $218.78 / $575.44	Professional		$177.83	$218.78	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $102.33 / $104.71	Facility	26	$100.00	$102.33	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $549.54 / $691.83	Professional		$489.78	$549.54	$691.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $309.03 / $467.74	Professional		$194.98	$309.03	$467.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $44.67 / $67.61	Professional	26	$30.90	$44.67	$67.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $102.33 / $138.04	Facility	26	$102.33	$102.33	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $316.23 / $776.25	Professional		$181.97	$316.23	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $489.78 / $588.84	Professional		$426.58	$489.78	$588.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $70.79 / $120.23	Professional	26	$60.26	$70.79	$120.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $588.84	Professional		$537.03	$537.03	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $275.42 / $549.54	Professional		$165.96	$275.42	$549.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $389.05 / $457.09	Professional		$309.03	$389.05	$457.09