Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $302.00 / $457.09	Facility		$91.20	$302.00	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $7.94 / $7.94	Facility	26	$7.94	$7.94	$7.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $316.23 / $630.96	Facility	TC	$40.74	$316.23	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $36.31 / $97.72	Professional		$7.76	$36.31	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $15.14 / $41.69	Professional	26	$7.59	$15.14	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $100.00 / $204.17	Professional	50	$44.67	$100.00	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.80 / $3.80 / $3.80	Professional	52	$3.80	$3.80	$3.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $50.12 / $208.93	Professional	TC	$25.12	$50.12	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $102.33	Professional		$64.57	$81.28	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $18.20 / $22.91	Professional	26	$14.45	$18.20	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $63.10 / $77.62	Professional	TC	$50.12	$63.10	$77.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $52.48 / $338.84	Facility		$37.15	$52.48	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $100.00	Professional		$28.84	$46.77	$100.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.60 / $29.51	Professional	26	$10.00	$16.60	$29.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.11 / $169.82	Professional	TC	$20.89	$33.11	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $69.18 / $72.44	Professional		$66.07	$69.18	$72.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.98 / $19.50	Professional	26	$16.22	$16.98	$19.50
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $50.12 / $54.95	Professional	TC	$48.98	$50.12	$54.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $17.38 / $17.38	Professional	26	$17.38	$17.38	$17.38
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $50.12 / $50.12	Professional	TC	$50.12	$50.12	$50.12
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $66.07	Professional		$34.67	$48.98	$66.07
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.49 / $15.49	Professional	26	$10.00	$13.49	$15.49
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $50.12	Professional	TC	$26.92	$36.31	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $72.44	Professional		$32.36	$48.98	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.13 / $18.20	Professional	26	$8.71	$14.13	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $35.48 / $51.29	Professional	TC	$23.44	$35.48	$51.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $69.18 / $69.18	Professional		$57.54	$69.18	$69.18
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.22 / $16.22	Professional	26	$13.80	$16.22	$16.22
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.48 / $52.48	Professional	TC	$44.67	$52.48	$52.48