Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.85 / $38.85 / $279.00	Facility		$38.85	$38.85	$279.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.99 / $10.99 / $10.99	Facility	26	$10.99	$10.99	$10.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.30 / $32.95 / $72.98	Professional		$16.30	$32.95	$72.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.91 / $16.30 / $32.40	Professional	26	$9.91	$16.30	$32.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.41 / $32.38 / $72.98	Professional	TC	$22.41	$32.38	$72.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.78 / $85.33 / $106.66	Professional		$69.78	$85.33	$106.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.67 / $24.05 / $30.06	Professional	26	$19.67	$24.05	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.57 / $61.28 / $76.59	Professional	TC	$49.57	$61.28	$76.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.82 / $55.69 / $65.66	Facility		$42.82	$55.69	$65.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.53 / $65.88 / $236.90	Professional		$39.53	$65.88	$236.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $20.95 / $82.56	Professional	26	$13.53	$20.95	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.00 / $43.75 / $190.00	Professional	TC	$26.00	$43.75	$190.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $63.14 / $76.48 / $124.53	Facility		$63.14	$76.48	$124.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $34.97 / $34.97 / $34.97	Facility	26	$34.97	$34.97	$34.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $76.48 / $93.62	Professional		$60.00	$76.48	$93.62
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.75 / $53.13 / $71.16	Professional		$38.75	$53.13	$71.16
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.72 / $18.16 / $20.70	Professional	26	$13.72	$18.16	$20.70
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.27 / $37.61 / $50.46	Professional	TC	$26.27	$37.61	$50.46
United Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $65.88 / $66.27	Professional		$42.76	$65.88	$66.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.38 / $20.38 / $24.30	Professional	26	$12.38	$20.38	$24.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $43.34 / $54.17	Professional	TC	$28.14	$43.34	$54.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $62.80 / $73.90 / $73.90	Professional		$62.80	$73.90	$73.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $21.50 / $21.50	Professional	26	$18.30	$21.50	$21.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.50 / $52.40 / $52.40	Professional	TC	$44.50	$52.40	$52.40