Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.04 / $39.04 / $39.04	Facility	26	$39.04	$39.04	$39.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.54 / $112.29 / $202.59	Professional		$110.54	$112.29	$202.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $59.15 / $153.97	Professional	26	$31.76	$59.15	$153.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.06 / $80.54 / $143.43	Professional	TC	$77.06	$80.54	$143.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.55 / $283.13 / $353.91	Professional		$231.55	$283.13	$353.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.05 / $86.88 / $108.60	Professional	26	$71.05	$86.88	$108.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.50 / $196.25 / $245.32	Professional	TC	$160.50	$196.25	$245.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.96 / $223.81 / $812.81	Professional		$134.96	$223.81	$812.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.59 / $72.65 / $240.49	Professional	26	$41.59	$72.65	$240.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.06 / $149.13 / $572.32	Professional	TC	$94.06	$149.13	$572.32
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $110.06 / $110.06 / $110.06	Facility	26	$110.06	$110.06	$110.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $257.60 / $312.26	Professional		$165.00	$257.60	$312.26
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $136.87 / $188.18 / $234.18	Professional		$136.87	$188.18	$234.18
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.82 / $58.99 / $73.75	Professional	26	$42.82	$58.99	$73.75
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $93.96 / $129.19 / $160.43	Professional	TC	$93.96	$129.19	$160.43
United Facility/Professional Professional Modifier Low / Median / High Price $135.65 / $179.95 / $226.08	Professional		$135.65	$179.95	$226.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.13 / $62.74 / $74.67	Professional	26	$45.13	$62.74	$74.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.06 / $125.40 / $164.59	Professional	TC	$94.06	$125.40	$164.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $206.70 / $243.20 / $243.20	Professional		$206.70	$243.20	$243.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $65.09 / $76.59 / $76.59	Professional	26	$65.09	$76.59	$76.59
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $141.60 / $166.60 / $166.60	Professional	TC	$141.60	$166.60	$166.60