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 $73.88 / $80.50 / $134.96	Professional		$73.88	$80.50	$134.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $51.21 / $105.02	Professional	26	$28.94	$51.21	$105.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.95 / $47.97 / $83.76	Professional	TC	$44.95	$47.97	$83.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.41 / $190.05 / $237.56	Professional		$155.41	$190.05	$237.56
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 $93.89 / $114.80 / $143.50	Professional	TC	$93.89	$114.80	$143.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.26 / $153.62 / $546.16	Professional		$93.26	$153.62	$546.16
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 $56.70 / $88.80 / $335.78	Professional	TC	$56.70	$88.80	$335.78
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 $169.13 / $185.08 / $214.50	Professional		$169.13	$185.08	$214.50
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $104.26 / $138.44 / $159.11	Professional		$104.26	$138.44	$159.11
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 $62.81 / $82.27 / $96.35	Professional	TC	$62.81	$82.27	$96.35
United Facility/Professional Professional Modifier Low / Median / High Price $98.66 / $132.18 / $165.22	Professional		$98.66	$132.18	$165.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $55.81 / $69.76	Professional	26	$39.14	$55.81	$69.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.27 / $81.14 / $95.46	Professional	TC	$57.27	$81.14	$95.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $139.30 / $163.90 / $163.90	Professional		$139.30	$163.90	$163.90
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 $82.80 / $97.40 / $97.40	Professional	TC	$82.80	$97.40	$97.40