Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $60.26 / $60.26	Facility	26	$47.86	$60.26	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $257.04 / $467.74	Professional		$181.97	$257.04	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $162.18	Professional	26	$56.23	$81.28	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $190.55 / $371.54	Professional	TC	$131.83	$190.55	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $602.56	Professional		$380.19	$478.63	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $138.04 / $169.82	Professional	26	$109.65	$138.04	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $338.84 / $426.58	Professional	TC	$275.42	$338.84	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $416.87 / $776.25	Professional		$234.42	$416.87	$776.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $117.49 / $194.98	Professional	26	$69.18	$117.49	$194.98
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $309.03 / $1,995.26	Professional	TC	$194.98	$309.03	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $426.58 / $512.86	Professional		$398.11	$426.58	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $125.89 / $162.18	Professional	26	$117.49	$125.89	$162.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $302.00 / $354.81	Professional	TC	$275.42	$302.00	$354.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $331.13 / $331.13	Professional	TC	$331.13	$331.13	$331.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $549.54	Professional		$263.03	$389.05	$549.54
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $100.00 / $114.82	Professional	26	$74.13	$100.00	$114.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $457.09	Professional	TC	$190.55	$275.42	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $436.52 / $602.56	Professional		$239.88	$436.52	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $117.49 / $147.91	Professional	26	$69.18	$117.49	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $302.00 / $457.09	Professional	TC	$169.82	$302.00	$457.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $446.68 / $446.68	Professional		$380.19	$446.68	$446.68
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $131.83 / $131.83	Professional	26	$112.20	$131.83	$131.83
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $316.23 / $316.23	Professional	TC	$269.15	$316.23	$316.23