Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.68 / $190.00 / $598.20	Facility	26	$105.68	$190.00	$598.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $113.31 / $561.60	Professional	26	$100.00	$113.31	$561.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $367.08 / $378.09 / $389.10	Facility	26	$367.08	$378.09	$389.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $241.23 / $259.08 / $323.85	Professional	26	$241.23	$259.08	$323.85
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.23 / $162.96 / $228.35	Professional	26	$106.23	$162.96	$228.35
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $378.09 / $378.09 / $378.09	Facility	26	$378.09	$378.09	$378.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $112.18 / $135.84 / $485.19	Professional	26	$112.18	$135.84	$485.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $378.09 / $389.10 / $634.08	Facility	26	$378.09	$389.10	$634.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.18 / $129.93 / $227.97	Professional	26	$108.18	$129.93	$227.97
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $170.32 / $215.60 / $253.70	Professional	26	$170.32	$215.60	$253.70