Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.45 / $339.99 / $625.50	Facility		$37.45	$339.99	$625.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.89 / $8.89 / $8.89	Facility	26	$8.89	$8.89	$8.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.57 / $28.57 / $225.30	Facility	TC	$28.57	$28.57	$225.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.47 / $31.37 / $74.76	Professional		$20.47	$31.37	$74.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $9.72 / $32.04	Professional	26	$8.36	$9.72	$32.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.53 / $27.40 / $75.65	Professional	TC	$22.53	$27.40	$75.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.88 / $83.00 / $103.75	Professional		$67.88	$83.00	$103.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $19.39 / $24.24	Professional	26	$15.86	$19.39	$24.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.41 / $63.61 / $79.51	Professional	TC	$51.41	$63.61	$79.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.45 / $52.29 / $64.08	Facility		$38.45	$52.29	$64.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $63.92 / $226.14	Professional		$38.35	$63.92	$226.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $16.95 / $55.28	Professional	26	$10.99	$16.95	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.73 / $46.22 / $170.86	Professional	TC	$27.73	$46.22	$170.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $62.19 / $73.83 / $121.14	Facility		$62.19	$73.83	$121.14
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $32.61 / $32.61 / $32.61	Facility	26	$32.61	$32.61	$32.61
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $77.27 / $77.27 / $77.27	Facility	TC	$77.27	$77.27	$77.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $62.19 / $73.83 / $89.13	Professional		$62.19	$73.83	$89.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $58.84 / $69.22	Professional		$40.65	$58.84	$69.22
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $14.75 / $16.82	Professional	26	$9.36	$14.75	$16.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.45 / $44.54 / $52.40	Professional	TC	$27.45	$44.54	$52.40
United Facility/Professional Professional Modifier Low / Median / High Price $39.10 / $51.14 / $65.16	Professional		$39.10	$51.14	$65.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $15.24 / $18.94	Professional	26	$10.38	$15.24	$18.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.85 / $36.90 / $46.97	Professional	TC	$28.85	$36.90	$46.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $61.10 / $71.90 / $71.90	Professional		$61.10	$71.90	$71.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.80 / $17.50 / $17.50	Professional	26	$14.80	$17.50	$17.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $46.20 / $54.40 / $54.40	Professional	TC	$46.20	$54.40	$54.40