Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $138.04 / $181.97	Facility	26	$75.86	$138.04	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $691.83	Professional		$112.20	$158.49	$691.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $281.84 / $288.40	Facility	26	$269.15	$281.84	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $316.23 / $398.11	Professional		$309.03	$316.23	$398.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $223.87 / $588.84	Professional		$134.90	$223.87	$588.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $144.54 / $354.81	Professional	26	$85.11	$144.54	$354.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $467.74	Facility	26	$281.84	$281.84	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $676.08	Professional		$134.90	$229.09	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $309.03 / $691.83	Professional		$269.15	$309.03	$691.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $190.55 / $549.54	Professional	26	$165.96	$190.55	$549.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	26	$288.40	$288.40	$288.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $363.08	Professional		$316.23	$316.23	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $316.23	Professional		$131.83	$169.82	$316.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $229.09 / $269.15	Professional		$181.97	$229.09	$269.15