Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $47.86 / $47.86	Facility	26	$34.67	$47.86	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $223.87 / $954.99	Professional		$120.23	$223.87	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $47.86 / $147.91	Professional	26	$43.65	$47.86	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $114.82 / $309.03	Professional	TC	$77.62	$114.82	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $316.23 / $398.11	Professional		$251.19	$316.23	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $109.65 / $138.04	Professional	26	$87.10	$109.65	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $208.93 / $257.04	Professional	TC	$165.96	$208.93	$257.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $281.84 / $524.81	Professional		$158.49	$281.84	$524.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $93.33 / $199.53	Professional	26	$58.88	$93.33	$199.53
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $199.53 / $1,318.26	Professional	TC	$125.89	$199.53	$1,318.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $281.84 / $371.54	Professional		$263.03	$281.84	$371.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $100.00 / $123.03	Professional	26	$95.50	$100.00	$123.03
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $181.97 / $245.47	Professional	TC	$165.96	$181.97	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Professional	26	$104.71	$104.71	$104.71
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $213.80	Professional	TC	$213.80	$213.80	$213.80
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $363.08	Professional		$173.78	$257.04	$363.08
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $91.20	Professional	26	$58.88	$79.43	$91.20
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $165.96 / $288.40	Professional	TC	$114.82	$165.96	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $288.40 / $407.38	Professional		$158.49	$288.40	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $114.82	Professional	26	$56.23	$87.10	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $194.98 / $288.40	Professional	TC	$104.71	$194.98	$288.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $302.00	Professional		$257.04	$302.00	$302.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $104.71 / $104.71	Professional	26	$89.13	$104.71	$104.71
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $194.98 / $194.98	Professional	TC	$165.96	$194.98	$194.98