Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.25 / $43.25 / $43.25	Facility	26	$43.25	$43.25	$43.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.45 / $125.19 / $229.07	Professional		$121.45	$125.19	$229.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $102.35 / $117.48	Professional	26	$31.76	$102.35	$117.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.96 / $89.70 / $163.71	Professional	TC	$87.96	$89.70	$163.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.00 / $320.36 / $400.46	Professional		$262.00	$320.36	$400.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.58 / $96.19 / $120.23	Professional	26	$77.58	$96.19	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.33 / $224.18 / $280.22	Professional	TC	$183.33	$224.18	$280.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $152.88 / $254.80 / $927.52	Professional		$152.88	$254.80	$927.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.59 / $72.79 / $268.38	Professional	26	$41.59	$72.79	$268.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $111.29 / $174.51 / $659.08	Professional	TC	$111.29	$174.51	$659.08
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $109.76 / $109.76 / $109.76	Facility	26	$109.76	$109.76	$109.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.00 / $291.06 / $368.51	Professional		$177.00	$291.06	$368.51
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $154.03 / $211.77 / $264.58	Professional		$154.03	$211.77	$264.58
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $60.77 / $81.51	Professional	26	$42.70	$60.77	$81.51
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $110.70 / $152.19 / $183.07	Professional	TC	$110.70	$152.19	$183.07
United Facility/Professional Professional Modifier Low / Median / High Price $165.97 / $254.80 / $301.83	Professional		$165.97	$254.80	$301.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.34 / $69.31 / $83.34	Professional	26	$45.34	$69.31	$83.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.29 / $142.28 / $185.48	Professional	TC	$111.29	$142.28	$185.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $233.50 / $274.70 / $274.70	Professional		$233.50	$274.70	$274.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $71.90 / $84.60 / $84.60	Professional	26	$71.90	$84.60	$84.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $161.60 / $190.10 / $190.10	Professional	TC	$161.60	$190.10	$190.10