Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.26 / $169.24 / $403.78	Facility		$34.26	$169.24	$403.78
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 $25.72 / $25.72 / $25.72	Facility	TC	$25.72	$25.72	$25.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.31 / $29.48 / $55.03	Professional		$29.31	$29.48	$55.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $10.25 / $30.26	Professional	26	$7.78	$10.25	$30.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.69 / $28.19 / $66.75	Professional	TC	$21.69	$28.19	$66.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $76.02 / $95.02	Professional		$62.17	$76.02	$95.02
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 $45.93 / $57.40 / $71.75	Professional	TC	$45.93	$57.40	$71.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.93 / $49.53 / $58.62	Facility		$36.93	$49.53	$58.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $56.34 / $208.83	Professional		$33.50	$56.34	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $16.27 / $82.56	Professional	26	$10.51	$16.27	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.99 / $40.22 / $176.00	Professional	TC	$22.99	$40.22	$176.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $67.50 / $110.95	Facility		$56.00	$67.50	$110.95
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.57 / $27.57 / $27.57	Facility	26	$27.57	$27.57	$27.57
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $67.51 / $67.51 / $67.51	Facility	TC	$67.51	$67.51	$67.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.40 / $67.50 / $81.67	Professional		$53.40	$67.50	$81.67
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $34.02 / $47.27 / $63.40	Professional		$34.02	$47.27	$63.40
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.73 / $14.19 / $16.17	Professional	26	$10.73	$14.19	$16.17
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.37 / $35.21 / $47.22	Professional	TC	$24.37	$35.21	$47.22
United Facility/Professional Professional Modifier Low / Median / High Price $34.90 / $46.35 / $57.91	Professional		$34.90	$46.35	$57.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $14.02 / $17.52	Professional	26	$9.98	$14.02	$17.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.99 / $32.70 / $41.64	Professional	TC	$22.99	$32.70	$41.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.00 / $65.80 / $65.80	Professional		$56.00	$65.80	$65.80
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 $41.70 / $49.00 / $49.00	Professional	TC	$41.70	$49.00	$49.00