Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.62 / $190.00 / $592.97	Facility	26	$104.62	$190.00	$592.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $113.40 / $534.30	Professional	26	$100.00	$113.40	$534.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $365.60 / $376.57 / $387.54	Facility	26	$365.60	$376.57	$387.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $239.82 / $256.76 / $320.95	Professional	26	$239.82	$256.76	$320.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $105.45 / $189.36 / $350.14	Professional	26	$105.45	$189.36	$350.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $376.57 / $376.57 / $376.57	Facility	26	$376.57	$376.57	$376.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $110.75 / $134.47 / $473.05	Professional	26	$110.75	$134.47	$473.05
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $376.57 / $387.54 / $626.46	Facility	26	$376.57	$387.54	$626.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.54 / $140.32 / $235.47	Professional	26	$115.54	$140.32	$235.47
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $168.82 / $213.70 / $251.40	Professional	26	$168.82	$213.70	$251.40