Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.47 / $43.47 / $43.47	Facility		$43.47	$43.47	$43.47
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 $32.47 / $32.47 / $32.47	Facility	TC	$32.47	$32.47	$32.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.19 / $38.29 / $69.70	Professional		$37.19	$38.29	$69.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $10.82 / $25.94	Professional	26	$9.51	$10.82	$25.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.48 / $27.68 / $53.05	Professional	TC	$27.48	$27.68	$53.05
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 $19.67 / $24.05 / $30.06	Professional	26	$19.67	$24.05	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.32 / $72.14 / $90.18	Professional	TC	$58.32	$72.14	$90.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.67 / $60.82 / $73.45	Facility		$45.67	$60.82	$73.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $73.93 / $265.10	Professional		$44.41	$73.93	$265.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $20.95 / $68.20	Professional	26	$13.58	$20.95	$68.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.75 / $52.98 / $196.89	Professional	TC	$33.75	$52.98	$196.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $75.91 / $85.10 / $140.38	Facility		$75.91	$85.10	$140.38
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $48.75 / $48.75 / $48.75	Facility	26	$48.75	$48.75	$48.75
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $115.14 / $115.14 / $115.14	Facility	TC	$115.14	$115.14	$115.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.91 / $85.10 / $103.29	Professional		$75.91	$85.10	$103.29
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $48.24 / $68.19 / $80.22	Professional		$48.24	$68.19	$80.22
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 $31.18 / $50.59 / $59.51	Professional	TC	$31.18	$50.59	$59.51
United Facility/Professional Professional Modifier Low / Median / High Price $47.95 / $71.93 / $83.50	Professional		$47.95	$71.93	$83.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $20.38 / $24.43	Professional	26	$12.78	$20.38	$24.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.75 / $45.01 / $56.26	Professional	TC	$33.75	$45.01	$56.26
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 $18.30 / $21.50 / $21.50	Professional	26	$18.30	$21.50	$21.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $52.50 / $61.80 / $61.80	Professional	TC	$52.50	$61.80	$61.80