Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.30 / $347.06 / $738.17	Facility		$94.30	$347.06	$738.17
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.24 / $9.24 / $257.48	Facility	26	$9.24	$9.24	$257.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.14 / $313.07 / $383.62	Facility	TC	$27.14	$313.07	$383.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.73 / $30.89 / $175.50	Professional		$8.73	$30.89	$175.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $9.19 / $34.20	Professional	26	$8.57	$9.19	$34.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.86 / $17.86 / $33.27	Professional	50	$17.86	$17.86	$33.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $51.52 / $264.60	Professional	TC	$23.44	$51.52	$264.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.98 / $80.67 / $100.84	Professional		$65.98	$80.67	$100.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $20.17 / $25.21	Professional	26	$16.48	$20.17	$25.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.79 / $60.50 / $75.63	Professional	TC	$44.79	$60.50	$75.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.62 / $56.50 / $365.68	Facility		$44.62	$56.50	$365.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.24 / $59.60 / $221.82	Professional		$33.24	$59.60	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $17.61 / $31.50	Professional	26	$11.42	$17.61	$31.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.42 / $40.99 / $177.00	Professional	TC	$23.42	$40.99	$177.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $68.02 / $117.74	Facility		$58.00	$68.02	$117.74
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $33.01 / $33.01 / $33.01	Facility	26	$33.01	$33.01	$33.01
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $69.61 / $69.61 / $69.61	Facility	TC	$69.61	$69.61	$69.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $55.48 / $66.78 / $88.17	Professional		$55.48	$66.78	$88.17
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $35.32 / $50.16 / $67.28	Professional		$35.32	$50.16	$67.28
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $15.32 / $17.47	Professional	26	$11.42	$15.32	$17.47
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.37 / $37.14 / $49.81	Professional	TC	$24.37	$37.14	$49.81
United Facility/Professional Professional Modifier Low / Median / High Price $37.40 / $57.98 / $63.02	Professional		$37.40	$57.98	$63.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.79 / $17.14 / $19.89	Professional	26	$10.79	$17.14	$19.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.04 / $72.73	Professional	TC	$25.70	$39.04	$72.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $69.90 / $69.90	Professional		$59.40	$69.90	$69.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.40 / $18.10 / $18.10	Professional	26	$15.40	$18.10	$18.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.00 / $51.70 / $51.70	Professional	TC	$44.00	$51.70	$51.70