Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.87 / $360.96 / $638.64	Facility		$128.87	$360.96	$638.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.53 / $8.53 / $8.53	Facility	26	$8.53	$8.53	$8.53
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.72 / $223.35 / $233.65	Facility	TC	$25.72	$223.35	$233.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.16 / $34.40 / $78.30	Professional		$8.16	$34.40	$78.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $8.53 / $33.29	Professional	26	$7.78	$8.53	$33.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.35 / $42.04 / $151.19	Professional	TC	$22.35	$42.04	$151.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $76.02 / $95.02	Professional		$62.17	$76.02	$95.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.23 / $18.62 / $23.27	Professional	26	$15.23	$18.62	$23.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.21 / $57.40 / $71.75	Professional	TC	$45.21	$57.40	$71.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.70 / $50.04 / $71.05	Facility		$40.70	$50.04	$71.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.42 / $57.24 / $208.83	Professional		$35.42	$57.24	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $16.26 / $74.30	Professional	26	$10.51	$16.26	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.20 / $40.98 / $176.00	Professional	TC	$26.20	$40.98	$176.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $65.94 / $110.95	Facility		$60.00	$65.94	$110.95
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.46 / $27.46 / $27.46	Facility	26	$27.46	$27.46	$27.46
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $83.81 / $83.81 / $83.81	Facility	TC	$83.81	$83.81	$83.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.94 / $82.28	Professional		$55.00	$65.94	$82.28
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.75 / $51.91 / $63.40	Professional		$37.75	$51.91	$63.40
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.76 / $14.19 / $16.17	Professional	26	$10.76	$14.19	$16.17
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $36.57 / $47.22	Professional	TC	$26.60	$36.57	$47.22
United Facility/Professional Professional Modifier Low / Median / High Price $37.13 / $55.69 / $88.23	Professional		$37.13	$55.69	$88.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $13.65 / $17.52	Professional	26	$9.98	$13.65	$17.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.58 / $33.59 / $47.02	Professional	TC	$26.58	$33.59	$47.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.00 / $65.80 / $65.80	Professional		$56.00	$65.80	$65.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $16.80 / $16.80	Professional	26	$14.30	$16.80	$16.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $41.70 / $49.00 / $49.00	Professional	TC	$41.70	$49.00	$49.00