Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.81 / $225.88 / $4,495.60	Facility		$37.81	$225.88	$4,495.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.89 / $8.89 / $8.89	Facility	26	$8.89	$8.89	$8.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.92 / $484.21 / $484.72	Facility	TC	$28.92	$484.21	$484.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $37.21 / $60.75	Professional		$32.34	$37.21	$60.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $13.48 / $42.72	Professional	26	$8.21	$13.48	$42.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $25.92 / $47.26	Professional	TC	$24.65	$25.92	$47.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.51 / $83.78 / $104.72	Professional		$68.51	$83.78	$104.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $19.39 / $24.24	Professional	26	$15.86	$19.39	$24.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.75 / $64.38 / $80.48	Professional	TC	$51.75	$64.38	$80.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.32 / $54.65 / $78.38	Facility		$46.32	$54.65	$78.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $65.92 / $230.47	Professional		$39.79	$65.92	$230.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $18.95 / $77.59	Professional	26	$12.29	$18.95	$77.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.16 / $46.94 / $214.00	Professional	TC	$28.16	$46.94	$214.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $68.00 / $84.45 / $122.26	Facility		$68.00	$84.45	$122.26
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $38.47 / $38.47 / $38.47	Facility	26	$38.47	$38.47	$38.47
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $83.73 / $83.73 / $83.73	Facility	TC	$83.73	$83.73	$83.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $76.84 / $90.84	Professional		$65.00	$76.84	$90.84
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $42.90 / $58.99 / $69.87	Professional		$42.90	$58.99	$69.87
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $15.69 / $20.89	Professional	26	$12.19	$15.69	$20.89
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $39.54 / $53.05	Professional	TC	$27.79	$39.54	$53.05
United Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $64.13 / $74.87	Professional		$42.76	$64.13	$74.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $18.43 / $25.40	Professional	26	$10.38	$18.43	$25.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.16 / $45.70 / $53.74	Professional	TC	$28.16	$45.70	$53.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $61.70 / $72.50 / $72.50	Professional		$61.70	$72.50	$72.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.80 / $17.50 / $17.50	Professional	26	$14.80	$17.50	$17.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $46.80 / $55.10 / $55.10	Professional	TC	$46.80	$55.10	$55.10