Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.59 / $228.42 / $404.70	Facility		$34.59	$228.42	$404.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.94 / $9.94 / $9.94	Facility	26	$9.94	$9.94	$9.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.66 / $24.66 / $302.48	Facility	TC	$24.66	$24.66	$302.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.61 / $34.14 / $55.39	Professional		$29.61	$34.14	$55.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $14.58 / $40.04	Professional	26	$9.44	$14.58	$40.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $35.52 / $240.30	Professional	TC	$23.10	$35.52	$240.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.80 / $76.79 / $95.99	Professional		$62.80	$76.79	$95.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.76 / $21.72 / $27.15	Professional	26	$17.76	$21.72	$27.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.73 / $55.07 / $68.84	Professional	TC	$43.73	$55.07	$68.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.41 / $50.04 / $94.59	Facility		$42.41	$50.04	$94.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.42 / $58.57 / $218.00	Professional		$37.42	$58.57	$218.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $18.94 / $87.52	Professional	26	$12.29	$18.94	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.35 / $39.63 / $206.00	Professional	TC	$25.35	$39.63	$206.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $64.30 / $75.72 / $112.07	Facility		$64.30	$75.72	$112.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $36.60 / $36.60 / $36.60	Facility	26	$36.60	$36.60	$36.60
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $74.94 / $74.94 / $74.94	Facility	TC	$74.94	$74.94	$74.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $62.27 / $70.44 / $82.86	Professional		$62.27	$70.44	$82.86
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $54.44 / $64.04	Professional		$38.90	$54.44	$64.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $16.45 / $19.14	Professional	26	$13.25	$16.45	$19.14
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.51 / $36.56 / $45.28	Professional	TC	$27.51	$36.56	$45.28
United Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $56.99 / $73.94	Professional		$37.99	$56.99	$73.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.58 / $16.91 / $22.54	Professional	26	$11.58	$16.91	$22.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.56 / $52.90	Professional	TC	$25.70	$38.56	$52.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $66.50 / $66.50	Professional		$56.50	$66.50	$66.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.50 / $19.50	Professional	26	$16.60	$19.50	$19.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $40.00 / $47.00 / $47.00	Professional	TC	$40.00	$47.00	$47.00