Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.19 / $28.19 / $28.19	Facility	26	$28.19	$28.19	$28.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $116.11 / $143.22	Professional		$101.09	$116.11	$143.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $28.19 / $148.00	Professional	26	$24.51	$28.19	$148.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.26 / $91.60 / $110.02	Professional	TC	$75.26	$91.60	$110.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.79 / $293.20 / $366.52	Professional		$239.79	$293.20	$366.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $62.83 / $78.54	Professional	26	$51.38	$62.83	$78.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.14 / $230.38 / $287.98	Professional	TC	$183.14	$230.38	$287.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.29 / $214.01 / $873.78	Professional		$122.29	$214.01	$873.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.27 / $53.96 / $198.13	Professional	26	$34.27	$53.96	$198.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $88.02 / $154.03 / $695.99	Professional	TC	$88.02	$154.03	$695.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $91.41 / $91.41 / $91.41	Facility	26	$91.41	$91.41	$91.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.40 / $249.64 / $332.68	Professional		$194.40	$249.64	$332.68
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $123.60 / $180.38 / $241.94	Professional		$123.60	$180.38	$241.94
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.17 / $47.09 / $53.69	Professional	26	$35.17	$47.09	$53.69
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $88.28 / $140.35 / $188.25	Professional	TC	$88.28	$140.35	$188.25
United Facility/Professional Professional Modifier Low / Median / High Price $137.84 / $182.78 / $254.78	Professional		$137.84	$182.78	$254.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $48.55 / $61.53	Professional	26	$33.54	$48.55	$61.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.26 / $137.68 / $175.18	Professional	TC	$103.26	$137.68	$175.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $213.50 / $251.20 / $251.20	Professional		$213.50	$251.20	$251.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $47.40 / $55.80 / $55.80	Professional	26	$47.40	$55.80	$55.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $166.10 / $195.50 / $195.50	Professional	TC	$166.10	$195.50	$195.50