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 / $181.97 / $489.78	Professional		$120.23	$181.97	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $70.79 / $173.78	Professional	26	$43.65	$70.79	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $112.20 / $288.40	Professional	TC	$79.43	$112.20	$288.40
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 / $204.17 / $257.04	Professional	TC	$165.96	$204.17	$257.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $281.84 / $512.86	Professional		$154.88	$281.84	$512.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $87.10 / $141.25	Professional	26	$54.95	$87.10	$141.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $194.98 / $1,318.26	Professional	TC	$125.89	$194.98	$1,318.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $281.84 / $363.08	Professional		$263.03	$281.84	$363.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $100.00 / $117.49	Professional	26	$95.50	$100.00	$117.49
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 / $77.62 / $91.20	Professional	26	$58.88	$77.62	$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 / $398.11	Professional		$158.49	$288.40	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $107.15	Professional	26	$54.95	$85.11	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $194.98 / $288.40	Professional	TC	$102.33	$194.98	$288.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $295.12 / $295.12	Professional		$251.19	$295.12	$295.12
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 $162.18 / $190.55 / $190.55	Professional	TC	$162.18	$190.55	$190.55