Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.77 / $297.04 / $660.57	Facility		$132.77	$297.04	$660.57
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.53 / $8.53 / $8.53	Facility	26	$8.53	$8.53	$8.53
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.74 / $314.11 / $395.57	Facility	TC	$20.74	$314.11	$395.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $27.94 / $46.92	Professional		$25.07	$27.94	$46.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $8.34 / $21.36	Professional	26	$7.89	$8.34	$21.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $33.92 / $215.38	Professional	TC	$18.53	$33.92	$215.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.65 / $64.38 / $80.48	Professional		$52.65	$64.38	$80.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.23 / $18.62 / $23.27	Professional	26	$15.23	$18.62	$23.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.43 / $45.77 / $57.21	Professional	TC	$37.43	$45.77	$57.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.90 / $43.23 / $78.11	Facility		$35.90	$43.23	$78.11
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $201.18 / $201.18 / $201.18	Facility	TC	$201.18	$201.18	$201.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.10 / $52.58 / $178.47	Professional		$34.10	$52.58	$178.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $16.26 / $77.59	Professional	26	$10.51	$16.26	$77.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.22 / $36.32 / $163.00	Professional	TC	$23.22	$36.32	$163.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $52.08 / $64.23 / $95.10	Facility		$52.08	$64.23	$95.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $29.32 / $29.32 / $29.32	Facility	26	$29.32	$29.32	$29.32
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $58.45 / $58.45 / $58.45	Facility	TC	$58.45	$58.45	$58.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $60.79 / $72.95	Professional		$52.00	$60.79	$72.95
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $46.19 / $54.34	Professional		$33.04	$46.19	$54.34
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $14.19 / $16.17	Professional	26	$10.68	$14.19	$16.17
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.44 / $38.17	Professional	TC	$21.88	$32.44	$38.17
United Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $49.24 / $63.74	Professional		$33.54	$49.24	$63.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $13.65 / $17.52	Professional	26	$9.98	$13.65	$17.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.55 / $34.67 / $46.22	Professional	TC	$23.55	$34.67	$46.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $56.40 / $56.40	Professional		$48.00	$56.40	$56.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $16.80 / $16.80	Professional	26	$14.30	$16.80	$16.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $33.70 / $39.60 / $39.60	Professional	TC	$33.70	$39.60	$39.60