Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.55 / $313.07 / $553.96	Facility		$104.55	$313.07	$553.96
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 $18.25 / $123.48 / $352.51	Facility	TC	$18.25	$123.48	$352.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $22.95 / $43.36	Professional		$19.14	$22.95	$43.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $8.63 / $24.30	Professional	26	$8.01	$8.63	$24.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.66 / $16.62 / $45.90	Professional	TC	$10.66	$16.62	$45.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.46 / $59.73 / $74.66	Professional		$44.46	$59.73	$74.66
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 $26.39 / $40.34 / $50.42	Professional	TC	$26.39	$40.34	$50.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.80 / $45.87 / $356.28	Facility		$27.80	$45.87	$356.28
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $284.45 / $284.45 / $284.45	Facility	TC	$284.45	$284.45	$284.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.59 / $41.29 / $165.42	Professional		$23.59	$41.29	$165.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.00 / $16.95 / $32.40	Professional	26	$11.00	$16.95	$32.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $12.66 / $21.10 / $110.07	Professional	TC	$12.66	$21.10	$110.07
Midlands Facility/Professional Facility Modifier Low / Median / High Price $38.78 / $55.08 / $88.31	Facility		$38.78	$55.08	$88.31
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $30.75 / $30.75 / $30.75	Facility	26	$30.75	$30.75	$30.75
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $35.47 / $35.47 / $35.47	Facility	TC	$35.47	$35.47	$35.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $55.08 / $64.84	Professional		$52.48	$55.08	$64.84
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $44.26 / $50.46	Professional		$31.40	$44.26	$50.46
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $14.75 / $16.82	Professional	26	$9.36	$14.75	$16.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $17.62 / $29.50 / $33.64	Professional	TC	$17.62	$29.50	$33.64
United Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $39.32 / $47.23	Professional		$28.50	$39.32	$47.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $16.48 / $18.22	Professional	26	$9.99	$16.48	$18.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $21.10 / $30.28	Professional	TC	$17.82	$21.10	$30.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $44.50 / $52.40 / $52.40	Professional		$44.50	$52.40	$52.40
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 $29.70 / $34.90 / $34.90	Professional	TC	$29.70	$34.90	$34.90