Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.71 / $262.07 / $626.62	Facility		$30.71	$262.07	$626.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.19 / $8.19 / $8.19	Facility	26	$8.19	$8.19	$8.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.52 / $22.52 / $22.52	Facility	TC	$22.52	$22.52	$22.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.92 / $28.51 / $59.63	Professional		$7.92	$28.51	$59.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.51 / $29.70	Professional	26	$7.08	$11.51	$29.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.98 / $30.84 / $64.08	Professional	TC	$20.98	$30.84	$64.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.83 / $68.26 / $85.33	Professional		$55.83	$68.26	$85.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.59 / $17.84 / $22.30	Professional	26	$14.59	$17.84	$22.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.82 / $50.42 / $63.03	Professional	TC	$40.82	$50.42	$63.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.61 / $44.41 / $63.72	Facility		$35.61	$44.41	$63.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $52.58 / $187.12	Professional		$31.57	$52.58	$187.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $15.60 / $67.70	Professional	26	$9.65	$15.60	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.99 / $36.97 / $160.00	Professional	TC	$22.99	$36.97	$160.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $51.91 / $59.53 / $99.61	Facility		$51.91	$59.53	$99.61
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.66 / $25.66 / $25.66	Facility	26	$25.66	$25.66	$25.66
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $69.59 / $69.59 / $69.59	Facility	TC	$69.59	$69.59	$69.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $59.53 / $73.73	Professional		$49.00	$59.53	$73.73
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $45.42 / $56.93	Professional		$33.04	$45.42	$56.93
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $13.62 / $15.53	Professional	26	$9.80	$13.62	$15.53
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $31.26 / $41.40	Professional	TC	$22.74	$31.26	$41.40
United Facility/Professional Professional Modifier Low / Median / High Price $32.64 / $43.52 / $54.40	Professional		$32.64	$43.52	$54.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $13.08 / $16.07	Professional	26	$9.59	$13.08	$16.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.79 / $29.02 / $38.32	Professional	TC	$22.79	$29.02	$38.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $50.20 / $59.10 / $59.10	Professional		$50.20	$59.10	$59.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $16.10 / $16.10	Professional	26	$13.70	$16.10	$16.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $36.50 / $43.00 / $43.00	Professional	TC	$36.50	$43.00	$43.00