Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.83 / $241.80 / $746.88	Facility		$115.83	$241.80	$746.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.83 / $7.83 / $7.83	Facility	26	$7.83	$7.83	$7.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.88 / $22.88 / $245.74	Facility	TC	$22.88	$22.88	$245.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.08 / $29.37 / $69.81	Professional		$12.08	$29.37	$69.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $9.86 / $29.37	Professional	26	$7.28	$9.86	$29.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.64 / $29.82 / $147.74	Professional	TC	$20.64	$29.82	$147.74
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 $13.96 / $17.07 / $21.33	Professional	26	$13.96	$17.07	$21.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.55 / $51.20 / $64.00	Professional	TC	$41.55	$51.20	$64.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.65 / $44.41 / $96.58	Facility		$33.65	$44.41	$96.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $51.80 / $187.12	Professional		$30.91	$51.80	$187.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $15.60 / $64.39	Professional	26	$10.08	$15.60	$64.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.83 / $36.46 / $161.00	Professional	TC	$20.83	$36.46	$161.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $61.95 / $99.61	Facility		$51.00	$61.95	$99.61
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.85 / $25.85 / $25.85	Facility	26	$25.85	$25.85	$25.85
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $65.75 / $65.75 / $65.75	Facility	TC	$65.75	$65.75	$65.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $49.30 / $61.95 / $73.28	Professional		$49.30	$61.95	$73.28
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $31.44 / $42.47 / $56.93	Professional		$31.44	$42.47	$56.93
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.06 / $13.05 / $14.88	Professional	26	$10.06	$13.05	$14.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.03 / $31.35 / $42.05	Professional	TC	$22.03	$31.35	$42.05
United Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $47.46 / $55.99	Professional		$31.97	$47.46	$55.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $15.17 / $16.80	Professional	26	$9.19	$15.17	$16.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.64 / $29.55 / $37.64	Professional	TC	$22.64	$29.55	$37.64
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 $13.10 / $15.40 / $15.40	Professional	26	$13.10	$15.40	$15.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.10 / $43.70 / $43.70	Professional	TC	$37.10	$43.70	$43.70