Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.22 / $29.22 / $29.22	Facility	26	$29.22	$29.22	$29.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.70 / $91.09 / $161.44	Professional		$87.70	$91.09	$161.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $28.28 / $78.30	Professional	26	$21.12	$28.28	$78.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.82 / $69.95 / $117.35	Professional	TC	$62.82	$69.95	$117.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.60 / $225.73 / $282.16	Professional		$184.60	$225.73	$282.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.11 / $65.16 / $81.45	Professional	26	$52.11	$65.16	$81.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.32 / $160.57 / $200.71	Professional	TC	$131.32	$160.57	$200.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.19 / $176.98 / $648.50	Professional		$106.19	$176.98	$648.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.65 / $48.38 / $180.32	Professional	26	$27.65	$48.38	$180.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $78.54 / $123.77 / $468.12	Professional	TC	$78.54	$123.77	$468.12
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $73.30 / $73.30 / $73.30	Facility	26	$73.30	$73.30	$73.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $204.95 / $257.36	Professional		$124.00	$204.95	$257.36
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $106.40 / $146.30 / $186.31	Professional		$106.40	$146.30	$186.31
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.14 / $41.00 / $54.99	Professional	26	$29.14	$41.00	$54.99
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $78.08 / $107.36 / $131.32	Professional	TC	$78.08	$107.36	$131.32
United Facility/Professional Professional Modifier Low / Median / High Price $116.27 / $176.98 / $185.83	Professional		$116.27	$176.98	$185.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.92 / $46.08 / $55.48	Professional	26	$29.92	$46.08	$55.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.28 / $123.77 / $151.41	Professional	TC	$80.28	$123.77	$151.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $164.40 / $193.40 / $193.40	Professional		$164.40	$193.40	$193.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $48.50 / $57.10 / $57.10	Professional	26	$48.50	$57.10	$57.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $115.90 / $136.40 / $136.40	Professional	TC	$115.90	$136.40	$136.40