Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	26	$40.74	$40.74	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $165.96 / $758.58	Professional		$97.72	$165.96	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $39.81 / $138.04	Professional	26	$36.31	$39.81	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $89.13 / $223.87	Professional	TC	$63.10	$89.13	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $257.04 / $323.59	Professional		$208.93	$257.04	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $93.33 / $117.49	Professional	26	$74.13	$93.33	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $165.96 / $208.93	Professional	TC	$131.83	$165.96	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $194.98 / $363.08	Professional		$104.71	$194.98	$363.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $81.28 / $147.91	Professional	26	$51.29	$81.28	$147.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $125.89 / $1,096.48	Professional	TC	$74.13	$125.89	$1,096.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $229.09 / $257.04	Professional		$213.80	$229.09	$257.04
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $85.11 / $97.72	Professional	26	$81.28	$85.11	$97.72
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $144.54 / $158.49	Professional	TC	$131.83	$144.54	$158.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	26	$89.13	$89.13	$89.13
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	TC	$147.91	$147.91	$147.91
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $275.42	Professional		$134.90	$190.55	$275.42
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $66.07 / $77.62	Professional	26	$48.98	$66.07	$77.62
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $123.03 / $223.87	Professional	TC	$87.10	$123.03	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $288.40	Professional		$128.82	$208.93	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $72.44 / $91.20	Professional	26	$42.66	$72.44	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $131.83 / $194.98	Professional	TC	$81.28	$131.83	$194.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $245.47	Professional		$208.93	$245.47	$245.47
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $91.20	Professional	26	$77.62	$91.20	$91.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $154.88 / $154.88	Professional	TC	$131.83	$154.88	$154.88