Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.45 / $40.45 / $40.45	Facility	26	$40.45	$40.45	$40.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.12 / $138.69 / $180.35	Professional		$98.12	$138.69	$180.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.12 / $100.62 / $118.51	Professional	TC	$63.12	$100.62	$118.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.81 / $252.88 / $316.10	Professional		$206.81	$252.88	$316.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.73 / $162.12 / $202.65	Professional	TC	$123.73	$162.12	$202.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.84 / $185.92 / $1,114.04	Professional		$110.84	$185.92	$1,114.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $61.33 / $107.33 / $909.46	Professional	TC	$61.33	$107.33	$909.46
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $131.33 / $131.33 / $131.33	Facility	26	$131.33	$131.33	$131.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $204.85 / $230.56 / $353.00	Professional		$204.85	$230.56	$353.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $112.40 / $178.17 / $209.60	Professional		$112.40	$178.17	$209.60
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $50.82 / $67.52 / $76.98	Professional	26	$50.82	$67.52	$76.98
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $71.50 / $112.73 / $133.75	Professional	TC	$71.50	$112.73	$133.75
United Facility/Professional Professional Modifier Low / Median / High Price $123.95 / $175.87 / $238.34	Professional		$123.95	$175.87	$238.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.22 / $102.22 / $115.75	Professional	TC	$68.22	$102.22	$115.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.00 / $217.60 / $217.60	Professional		$185.00	$217.60	$217.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $117.00 / $137.69 / $137.69	Professional	TC	$117.00	$137.69	$137.69