Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $187.03 / $357.32 / $657.75	Facility	26	$187.03	$357.32	$657.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.66 / $102.84 / $645.37	Professional	26	$97.66	$102.84	$645.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $368.54 / $379.60 / $390.65	Facility	26	$368.54	$379.60	$390.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $216.78 / $247.69 / $307.37	Professional	26	$216.78	$247.69	$307.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.21 / $167.67 / $348.02	Professional	26	$102.21	$167.67	$348.02
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $379.60 / $379.60 / $379.60	Facility	26	$379.60	$379.60	$379.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $112.19 / $134.63 / $466.97	Professional	26	$112.19	$134.63	$466.97
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $379.60 / $390.65 / $600.60	Facility	26	$379.60	$390.65	$600.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.19 / $129.02 / $216.53	Professional	26	$112.19	$129.02	$216.53
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $147.02 / $186.10 / $219.00	Professional	26	$147.02	$186.10	$219.00