Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $19.05 / $25.70	Facility	26	$19.05	$19.05	$25.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $107.15 / $263.03	Professional		$66.07	$107.15	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $37.15 / $97.72	Professional	26	$18.20	$37.15	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $158.49 / $199.53	Professional		$79.43	$158.49	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $39.81 / $50.12	Professional	26	$33.88	$39.81	$50.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $194.98	Professional		$64.57	$85.11	$194.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.44 / $44.67	Professional	26	$17.38	$23.44	$44.67
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $117.49 / $512.86	Professional		$58.88	$117.49	$512.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $32.36 / $123.03	Professional	26	$19.05	$32.36	$123.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $147.91 / $181.97	Professional		$58.88	$147.91	$181.97
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $45.71 / $51.29	Professional	26	$38.90	$45.71	$51.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $144.54	Professional		$102.33	$144.54	$144.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $40.74 / $269.15	Professional	26	$36.31	$40.74	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $190.55	Professional		$54.95	$104.71	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $30.90 / $52.48	Professional	26	$18.62	$30.90	$52.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $173.78	Professional		$114.82	$147.91	$173.78
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.02 / $44.67	Professional	26	$30.20	$38.02	$44.67