Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.38 / $284.44 / $485.32	Facility		$50.38	$284.44	$485.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.18 / $8.18 / $8.18	Facility	26	$8.18	$8.18	$8.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $79.59 / $313.07 / $809.62	Facility	TC	$79.59	$313.07	$809.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.78 / $31.94 / $95.88	Professional		$7.78	$31.94	$95.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $13.18 / $41.40	Professional	26	$7.59	$13.18	$41.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.24 / $63.92 / $110.30	Professional	50	$30.24	$63.92	$110.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.42 / $15.42 / $18.02	Professional	52	$15.42	$15.42	$18.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.17 / $50.54 / $225.90	Professional	TC	$24.17	$50.54	$225.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.70 / $79.12 / $98.90	Professional		$64.70	$79.12	$98.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.59 / $17.84 / $22.30	Professional	26	$14.59	$17.84	$22.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.50 / $61.28 / $76.59	Professional	TC	$49.50	$61.28	$76.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.86 / $52.10 / $224.08	Facility		$37.86	$52.10	$224.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.59 / $58.95 / $221.82	Professional		$32.59	$58.95	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $16.76 / $29.70	Professional	26	$10.11	$16.76	$29.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.71 / $43.24 / $170.86	Professional	TC	$24.71	$43.24	$170.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $55.41 / $69.06 / $115.47	Facility		$55.41	$69.06	$115.47
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.55 / $26.55 / $26.55	Facility	26	$26.55	$26.55	$26.55
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $77.58 / $77.58 / $77.58	Facility	TC	$77.58	$77.58	$77.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $69.06 / $86.98	Professional		$53.00	$69.06	$86.98
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $34.90 / $49.19 / $65.98	Professional		$34.90	$49.19	$65.98
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $13.62 / $15.53	Professional	26	$10.30	$13.62	$15.53
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.98 / $37.61 / $50.46	Professional	TC	$24.98	$37.61	$50.46
United Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $58.95 / $74.97	Professional		$39.29	$58.95	$74.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $10.99 / $16.80	Professional	26	$9.59	$10.99	$16.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.84 / $35.33 / $44.99	Professional	TC	$26.84	$35.33	$44.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.20 / $68.50 / $68.50	Professional		$58.20	$68.50	$68.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $16.10 / $16.10	Professional	26	$13.70	$16.10	$16.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.50 / $52.40 / $52.40	Professional	TC	$44.50	$52.40	$52.40