Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.82 / $374.82 / $689.76	Facility		$118.82	$374.82	$689.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.53 / $8.53 / $114.92	Facility	26	$8.53	$8.53	$114.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.61 / $327.49 / $358.29	Facility	TC	$34.61	$327.49	$358.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.11 / $29.70 / $88.20	Professional		$8.11	$29.70	$88.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $8.52 / $32.40	Professional	26	$7.92	$8.52	$32.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $49.58 / $174.44	Professional	TC	$29.34	$49.58	$174.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $96.19 / $120.23	Professional		$78.66	$96.19	$120.23
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 $60.43 / $77.56 / $96.96	Professional	TC	$60.43	$77.56	$96.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.48 / $62.85 / $147.63	Facility		$45.48	$62.85	$147.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.54 / $70.90 / $263.06	Professional		$42.54	$70.90	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $16.97 / $67.70	Professional	26	$10.51	$16.97	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.03 / $54.16 / $209.88	Professional	TC	$32.03	$54.16	$209.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $67.51 / $80.78 / $140.38	Facility		$67.51	$80.78	$140.38
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.73 / $27.73 / $27.73	Facility	26	$27.73	$27.73	$27.73
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $94.91 / $94.91 / $94.91	Facility	TC	$94.91	$94.91	$94.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $80.78 / $103.62	Professional		$53.00	$80.78	$103.62
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $42.48 / $59.81 / $80.22	Professional		$42.48	$59.81	$80.22
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 $32.29 / $47.75 / $64.04	Professional	TC	$32.29	$47.75	$64.04
United Facility/Professional Professional Modifier Low / Median / High Price $46.66 / $70.90 / $74.45	Professional		$46.66	$70.90	$74.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $15.82 / $18.39	Professional	26	$9.99	$15.82	$18.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.78 / $43.73 / $55.67	Professional	TC	$34.78	$43.73	$55.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.80 / $83.30 / $83.30	Professional		$70.80	$83.30	$83.30
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 $56.50 / $66.50 / $66.50	Professional	TC	$56.50	$66.50	$66.50