Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.66 / $336.90 / $619.94	Facility	26	$149.66	$336.90	$619.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.00 / $100.00 / $508.81	Professional	26	$87.00	$100.00	$508.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $330.29 / $340.20 / $350.11	Facility	26	$330.29	$340.20	$350.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $214.19 / $229.61 / $287.01	Professional	26	$214.19	$229.61	$287.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $94.26 / $164.83 / $201.84	Professional	26	$94.26	$164.83	$201.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $340.20 / $340.20 / $340.20	Facility	26	$340.20	$340.20	$340.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $99.08 / $119.99 / $428.93	Professional	26	$99.08	$119.99	$428.93
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $340.20 / $350.11 / $562.50	Facility	26	$340.20	$350.11	$562.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.08 / $114.77 / $201.38	Professional	26	$99.08	$114.77	$201.38
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $152.63 / $193.20 / $227.30	Professional	26	$152.63	$193.20	$227.30