Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.78 / $33.78 / $33.78	Facility	26	$33.78	$33.78	$33.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.72 / $107.06 / $181.31	Professional		$98.72	$107.06	$181.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $51.21 / $90.90	Professional	26	$28.94	$51.21	$90.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.79 / $81.98 / $533.70	Professional	TC	$69.79	$81.98	$533.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.44 / $253.65 / $317.07	Professional		$207.44	$253.65	$317.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.53 / $75.23 / $94.05	Professional	26	$61.53	$75.23	$94.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.91 / $178.41 / $223.01	Professional	TC	$145.91	$178.41	$223.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.12 / $202.61 / $730.62	Professional		$122.12	$202.61	$730.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.86 / $64.81 / $210.44	Professional	26	$41.86	$64.81	$210.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $88.02 / $137.79 / $520.19	Professional	TC	$88.02	$137.79	$520.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $102.26 / $102.26 / $102.26	Facility	26	$102.26	$102.26	$102.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.07 / $242.38 / $279.83	Professional		$223.07	$242.38	$279.83
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $139.02 / $183.84 / $212.99	Professional		$139.02	$183.84	$212.99
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $41.45 / $56.17 / $64.04	Professional	26	$41.45	$56.17	$64.04
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.56 / $127.67 / $150.22	Professional	TC	$97.56	$127.67	$150.22
United Facility/Professional Professional Modifier Low / Median / High Price $119.85 / $174.32 / $228.80	Professional		$119.85	$174.32	$228.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $54.54 / $69.76	Professional	26	$39.14	$54.54	$69.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.88 / $108.29 / $148.13	Professional	TC	$88.88	$108.29	$148.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.00 / $217.60 / $217.60	Professional		$185.00	$217.60	$217.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $56.50 / $66.50 / $66.50	Professional	26	$56.50	$66.50	$66.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $128.50 / $151.10 / $151.10	Professional	TC	$128.50	$151.10	$151.10