Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.13 / $27.13 / $27.13	Facility	26	$27.13	$27.13	$27.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $118.90 / $219.82	Professional		$26.25	$118.90	$219.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $26.25 / $42.58	Professional	26	$23.37	$26.25	$42.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.70 / $95.53 / $178.18	Professional	TC	$83.70	$95.53	$178.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.95 / $304.85 / $381.06	Professional		$245.95	$304.85	$381.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $61.28 / $76.59	Professional	26	$50.12	$61.28	$76.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.36 / $243.57 / $304.45	Professional	TC	$182.36	$243.57	$304.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.41 / $210.71 / $859.12	Professional		$120.41	$210.71	$859.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.81 / $50.82 / $211.35	Professional	26	$32.81	$50.82	$211.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $87.60 / $153.30 / $689.44	Professional	TC	$87.60	$153.30	$689.44
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $87.88 / $87.88 / $87.88	Facility	26	$87.88	$87.88	$87.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $191.46 / $245.95 / $335.08	Professional		$191.46	$245.95	$335.08
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $125.14 / $187.13 / $251.00	Professional		$125.14	$187.13	$251.00
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.59 / $45.39 / $51.75	Professional	26	$33.59	$45.39	$51.75
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $89.84 / $148.55 / $199.25	Professional	TC	$89.84	$148.55	$199.25
United Facility/Professional Professional Modifier Low / Median / High Price $140.69 / $200.68 / $287.30	Professional		$140.69	$200.68	$287.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.56 / $49.45 / $54.68	Professional	26	$31.56	$49.45	$54.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.46 / $136.62 / $173.83	Professional	TC	$102.46	$136.62	$173.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $221.50 / $260.60 / $260.60	Professional		$221.50	$260.60	$260.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $45.70 / $53.70 / $53.70	Professional	26	$45.70	$53.70	$53.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $175.90 / $206.90 / $206.90	Professional	TC	$175.90	$206.90	$206.90