Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.19 / $381.61 / $770.22	Facility		$129.19	$381.61	$770.22
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 $30.35 / $245.74 / $383.62	Facility	TC	$30.35	$245.74	$383.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.26 / $36.90 / $158.41	Professional		$8.26	$36.90	$158.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $12.99 / $61.10	Professional	26	$7.89	$12.99	$61.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $13.50 / $13.50 / $16.52	Professional	50	$13.50	$13.50	$16.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.17 / $57.86 / $210.60	Professional	TC	$26.17	$57.86	$210.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.05 / $86.88 / $108.60	Professional		$71.05	$86.88	$108.60
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 $53.23 / $68.26 / $85.33	Professional	TC	$53.23	$68.26	$85.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.20 / $56.70 / $129.60	Facility		$41.20	$56.70	$129.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.95 / $62.84 / $234.86	Professional		$36.95	$62.84	$234.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $16.69 / $29.70	Professional	26	$10.55	$16.69	$29.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.44 / $46.26 / $181.68	Professional	TC	$26.44	$46.26	$181.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $58.77 / $73.77 / $126.81	Facility		$58.77	$73.77	$126.81
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 $78.64 / $78.64 / $78.64	Facility	TC	$78.64	$78.64	$78.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $73.77 / $92.51	Professional		$53.00	$73.77	$92.51
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.46 / $54.02 / $72.45	Professional		$37.46	$54.02	$72.45
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.73 / $14.19 / $16.17	Professional	26	$10.73	$14.19	$16.17
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.70 / $41.96 / $56.28	Professional	TC	$26.70	$41.96	$56.28
United Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $61.58 / $76.98	Professional		$39.89	$61.58	$76.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $14.89 / $17.52	Professional	26	$9.99	$14.89	$17.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.72 / $34.75 / $48.32	Professional	TC	$28.72	$34.75	$48.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.90 / $75.20 / $75.20	Professional		$63.90	$75.20	$75.20
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 $49.70 / $58.40 / $58.40	Professional	TC	$49.70	$58.40	$58.40