Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.58 / $243.20 / $433.08	Facility		$86.58	$243.20	$433.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.83 / $7.83 / $7.83	Facility	26	$7.83	$7.83	$7.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.37 / $245.74 / $296.39	Facility	TC	$25.37	$245.74	$296.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.69 / $29.70 / $65.86	Professional		$18.69	$29.70	$65.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $13.18 / $31.50	Professional	26	$7.45	$13.18	$31.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.94 / $35.93 / $68.40	Professional	TC	$19.94	$35.93	$68.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $73.69 / $92.11	Professional		$60.27	$73.69	$92.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $17.07 / $21.33	Professional	26	$13.96	$17.07	$21.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.93 / $56.63 / $70.78	Professional	TC	$45.93	$56.63	$70.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.45 / $48.00 / $82.18	Facility		$37.45	$48.00	$82.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $56.57 / $202.34	Professional		$33.94	$56.57	$202.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $14.93 / $75.00	Professional	26	$9.69	$14.93	$75.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.29 / $40.51 / $163.00	Professional	TC	$24.29	$40.51	$163.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $54.67 / $65.08 / $107.56	Facility		$54.67	$65.08	$107.56
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.53 / $27.53 / $27.53	Facility	26	$27.53	$27.53	$27.53
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $63.97 / $63.97 / $63.97	Facility	TC	$63.97	$63.97	$63.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $65.08 / $79.47	Professional		$52.00	$65.08	$79.47
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $46.28 / $61.46	Professional		$33.08	$46.28	$61.46
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $13.05 / $14.88	Professional	26	$9.98	$13.05	$14.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $34.72 / $46.58	Professional	TC	$22.85	$34.72	$46.58
United Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $45.82 / $57.28	Professional		$34.36	$45.82	$57.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $13.44 / $16.80	Professional	26	$9.19	$13.44	$16.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.63 / $32.70 / $41.64	Professional	TC	$25.63	$32.70	$41.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.20 / $63.80 / $63.80	Professional		$54.20	$63.80	$63.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $15.40 / $15.40	Professional	26	$13.10	$15.40	$15.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $41.10 / $48.40 / $48.40	Professional	TC	$41.10	$48.40	$48.40