Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $57.54 / $57.54	Facility	26	$40.74	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $190.55 / $467.74	Professional		$125.89	$190.55	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $79.43 / $194.98	Professional	26	$53.70	$79.43	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $223.87	Professional	TC	$77.62	$112.20	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $331.13 / $416.87	Professional		$263.03	$331.13	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $131.83 / $162.18	Professional	26	$104.71	$131.83	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $199.53 / $251.19	Professional	TC	$162.18	$199.53	$251.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $251.19 / $457.09	Professional		$131.83	$251.19	$457.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $100.00 / $165.96	Professional	26	$60.26	$100.00	$165.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $154.88 / $1,659.59	Professional	TC	$91.20	$154.88	$1,659.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $295.12 / $331.13	Professional		$275.42	$295.12	$331.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $117.49 / $138.04	Professional	26	$112.20	$117.49	$138.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $177.83 / $194.98	Professional	TC	$162.18	$177.83	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	26	$123.03	$123.03	$123.03
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	TC	$181.97	$181.97	$181.97
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $245.47 / $346.74	Professional		$177.83	$245.47	$346.74
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $93.33 / $107.15	Professional	26	$69.18	$93.33	$107.15
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $151.36 / $269.15	Professional	TC	$107.15	$151.36	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $257.04 / $371.54	Professional		$165.96	$257.04	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $100.00 / $128.82	Professional	26	$58.88	$100.00	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $162.18 / $234.42	Professional	TC	$100.00	$162.18	$234.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $316.23	Professional		$269.15	$316.23	$316.23
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $125.89 / $125.89	Professional	26	$107.15	$125.89	$125.89
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $186.21 / $186.21	Professional	TC	$158.49	$186.21	$186.21