Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	26	$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $165.96	Professional		$97.72	$114.82	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $74.13 / $114.82	Professional	TC	$63.10	$74.13	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $257.04 / $323.59	Professional		$208.93	$257.04	$323.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $165.96 / $208.93	Professional	TC	$131.83	$165.96	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $263.03	Professional		$102.33	$147.91	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $87.10 / $912.01	Professional	TC	$53.70	$87.10	$912.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $218.78 / $229.09	Professional		$213.80	$218.78	$229.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $85.11 / $95.50	Professional	26	$79.43	$85.11	$95.50
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $134.90 / $144.54	Professional	TC	$123.03	$134.90	$144.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	TC	$125.89	$125.89	$125.89
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $208.93	Professional		$120.23	$165.96	$208.93
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $66.07 / $77.62	Professional	26	$48.98	$66.07	$77.62
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $112.20 / $131.83	Professional	TC	$70.79	$112.20	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $239.88	Professional		$109.65	$177.83	$239.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $102.33 / $151.36	Professional	TC	$61.66	$102.33	$151.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $218.78 / $218.78	Professional		$186.21	$218.78	$218.78
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $138.04 / $138.04	Professional	TC	$117.49	$138.04	$138.04