Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $331.13 / $524.81	Facility		$120.23	$331.13	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $131.83 / $245.47	Facility	TC	$33.11	$131.83	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $38.90 / $100.00	Professional		$8.71	$38.90	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $15.85 / $46.77	Professional	26	$8.51	$15.85	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $60.26 / $154.88	Professional	50	$33.11	$60.26	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $51.29 / $245.47	Professional	TC	$28.84	$51.29	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $97.72 / $120.23	Professional		$77.62	$97.72	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $20.42 / $25.70	Professional	26	$16.60	$20.42	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $75.86 / $95.50	Professional	TC	$60.26	$75.86	$95.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $61.66 / $354.81	Facility		$44.67	$61.66	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $57.54 / $104.71	Professional		$35.48	$57.54	$104.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $17.38 / $31.62	Professional	26	$10.47	$17.38	$31.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $41.69 / $204.17	Professional	TC	$26.30	$41.69	$204.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $83.18 / $87.10	Professional		$79.43	$83.18	$87.10
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $19.05 / $21.88	Professional	26	$18.20	$19.05	$21.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $61.66 / $79.43	Professional	TC	$60.26	$61.66	$79.43
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	26	$19.50	$19.50	$19.50
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $60.26 / $79.43	Professional	TC	$60.26	$60.26	$79.43
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $79.43	Professional		$43.65	$58.88	$79.43
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $15.49 / $17.38	Professional	26	$11.22	$15.49	$17.38
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $44.67 / $61.66	Professional	TC	$32.36	$44.67	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $89.13	Professional		$39.81	$60.26	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.22 / $20.42	Professional	26	$9.55	$16.22	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $44.67 / $66.07	Professional	TC	$28.84	$44.67	$66.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $81.28	Professional		$69.18	$81.28	$81.28
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.20 / $18.20	Professional	26	$15.49	$18.20	$18.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.10 / $63.10	Professional	TC	$53.70	$63.10	$63.10