Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.56 / $143.41 / $429.78	Facility	26	$77.56	$143.41	$429.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.06 / $127.72 / $856.51	Professional		$119.06	$127.72	$856.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $272.18 / $280.35 / $288.51	Facility	26	$272.18	$280.35	$288.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.18 / $312.61 / $390.76	Professional		$266.18	$312.61	$390.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $121.87 / $203.48 / $515.28	Professional		$121.87	$203.48	$515.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.88 / $127.99 / $300.85	Professional	26	$77.88	$127.99	$300.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $280.35 / $280.35 / $280.35	Facility	26	$280.35	$280.35	$280.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.71 / $217.48 / $673.48	Professional		$138.71	$217.48	$673.48
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $280.35 / $288.51 / $465.90	Facility	26	$280.35	$288.51	$465.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $224.81 / $287.50 / $399.91	Professional		$224.81	$287.50	$399.91
United Facility/Professional Professional Modifier Low / Median / High Price $132.61 / $159.13 / $269.48	Professional		$132.61	$159.13	$269.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $182.25 / $230.70 / $271.39	Professional		$182.25	$230.70	$271.39