Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.34 / $264.13 / $561.63	Facility		$74.34	$264.13	$561.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.99 / $10.99 / $10.99	Facility	26	$10.99	$10.99	$10.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.53 / $296.37 / $383.62	Facility	TC	$38.53	$296.37	$383.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.38 / $33.68 / $99.68	Professional		$10.38	$33.68	$99.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $10.85 / $43.61	Professional	26	$10.15	$10.85	$43.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.86 / $38.24 / $208.26	Professional	TC	$29.86	$38.24	$208.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.35 / $111.70 / $139.63	Professional		$91.35	$111.70	$139.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.67 / $24.05 / $30.06	Professional	26	$19.67	$24.05	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.62 / $87.65 / $109.57	Professional	TC	$67.62	$87.65	$109.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.84 / $72.56 / $283.19	Facility		$49.84	$72.56	$283.19
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $344.10 / $344.10 / $346.36	Facility	TC	$344.10	$344.10	$346.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.16 / $83.12 / $301.95	Professional		$46.16	$83.12	$301.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $20.94 / $40.50	Professional	26	$13.52	$20.94	$40.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.35 / $60.58 / $233.75	Professional	TC	$36.35	$60.58	$233.75
Midlands Facility/Professional Facility Modifier Low / Median / High Price $79.27 / $95.24 / $161.91	Facility		$79.27	$95.24	$161.91
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $47.28 / $47.28 / $47.28	Facility	26	$47.28	$47.28	$47.28
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $124.01 / $124.01 / $124.01	Facility	TC	$124.01	$124.01	$124.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $95.24 / $119.26	Professional		$79.27	$95.24	$119.26
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $52.33 / $78.64 / $92.51	Professional		$52.33	$78.64	$92.51
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.53 / $18.16 / $20.70	Professional	26	$11.53	$18.16	$20.70
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.94 / $61.04 / $71.81	Professional	TC	$36.94	$61.04	$71.81
United Facility/Professional Professional Modifier Low / Median / High Price $54.16 / $81.68 / $87.28	Professional		$54.16	$81.68	$87.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.74 / $13.59 / $22.54	Professional	26	$12.74	$13.59	$22.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.44 / $49.50 / $63.01	Professional	TC	$39.44	$49.50	$63.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $96.10 / $96.10	Professional		$81.59	$96.10	$96.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $21.50 / $21.50	Professional	26	$18.30	$21.50	$21.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $63.40 / $74.59 / $74.59	Professional	TC	$63.40	$74.59	$74.59