Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.44 / $291.31 / $536.34	Facility	26	$131.44	$291.31	$536.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.00 / $100.00 / $536.04	Professional	26	$87.00	$100.00	$536.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $288.77 / $297.44 / $306.11	Facility	26	$288.77	$297.44	$306.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $188.58 / $202.46 / $253.07	Professional	26	$188.58	$202.46	$253.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.95 / $135.13 / $175.35	Professional	26	$82.95	$135.13	$175.35
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $297.44 / $297.44 / $297.44	Facility	26	$297.44	$297.44	$297.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $86.40 / $104.85 / $378.72	Professional	26	$86.40	$104.85	$378.72
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $297.44 / $306.11 / $496.26	Facility	26	$297.44	$306.11	$496.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.33 / $100.29 / $203.76	Professional	26	$86.33	$100.29	$203.76
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $134.38 / $170.10 / $200.10	Professional	26	$134.38	$170.10	$200.10