Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.71 / $25.71 / $25.71	Facility	26	$25.71	$25.71	$25.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.14 / $112.54 / $206.56	Professional		$92.14	$112.54	$206.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.66 / $24.89 / $101.46	Professional	26	$23.66	$24.89	$101.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.84 / $90.38 / $167.75	Professional	TC	$67.84	$90.38	$167.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.22 / $286.23 / $357.79	Professional		$220.22	$286.23	$357.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.31 / $56.63 / $70.78	Professional	26	$46.31	$56.63	$70.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.81 / $229.61 / $287.01	Professional	TC	$160.81	$229.61	$287.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.56 / $241.76 / $841.81	Professional		$144.56	$241.76	$841.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.94 / $49.23 / $205.77	Professional	26	$31.94	$49.23	$205.77
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $122.48 / $192.53 / $680.78	Professional	TC	$122.48	$192.53	$680.78
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $84.02 / $84.02 / $84.02	Facility	26	$84.02	$84.02	$84.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $139.00 / $265.37 / $318.27	Professional		$139.00	$265.37	$318.27
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $129.44 / $207.10 / $242.15	Professional		$129.44	$207.10	$242.15
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.60 / $42.56 / $48.52	Professional	26	$32.60	$42.56	$48.52
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $103.69 / $164.55 / $193.97	Professional	TC	$103.69	$164.55	$193.97
United Facility/Professional Professional Modifier Low / Median / High Price $149.40 / $192.75 / $257.38	Professional		$149.40	$192.75	$257.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.96 / $42.59 / $53.24	Professional	26	$29.96	$42.59	$53.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.44 / $163.31 / $204.14	Professional	TC	$119.44	$163.31	$204.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $208.40 / $245.20 / $245.20	Professional		$208.40	$245.20	$245.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $42.80 / $50.40 / $50.40	Professional	26	$42.80	$50.40	$50.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $165.60 / $194.80 / $194.80	Professional	TC	$165.60	$194.80	$194.80