Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $136.35 / $303.74 / $559.17	Facility	26	$136.35	$303.74	$559.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.00 / $100.00 / $538.49	Professional	26	$87.00	$100.00	$538.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $300.57 / $309.58 / $318.60	Facility	26	$300.57	$309.58	$318.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $192.15 / $206.34 / $257.92	Professional	26	$192.15	$206.34	$257.92
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.64 / $135.12 / $184.60	Professional	26	$84.64	$135.12	$184.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $309.58 / $309.58 / $309.58	Facility	26	$309.58	$309.58	$309.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.39 / $105.89 / $390.93	Professional	26	$89.39	$105.89	$390.93
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $309.58 / $318.60 / $508.20	Facility	26	$309.58	$318.60	$508.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.39 / $103.31 / $177.71	Professional	26	$89.39	$103.31	$177.71
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $136.91 / $173.30 / $203.90	Professional	26	$136.91	$173.30	$203.90