Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $22.91	Facility	26	$22.91	$22.91	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $295.12	Professional		$125.89	$147.91	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $125.89 / $177.83	Professional	TC	$107.15	$125.89	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $338.84 / $416.87	Professional		$269.15	$338.84	$416.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $281.84 / $354.81	Professional	TC	$218.78	$281.84	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $162.18 / $309.03	Professional		$117.49	$162.18	$309.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $134.90 / $776.25	Professional	TC	$91.20	$134.90	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $275.42 / $295.12	Professional		$269.15	$275.42	$295.12
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $48.98 / $56.23	Professional	26	$45.71	$48.98	$56.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $229.09 / $245.47	Professional	TC	$213.80	$229.09	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	TC	$218.78	$218.78	$218.78
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $186.21 / $269.15	Professional		$144.54	$186.21	$269.15
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $44.67	Professional	26	$28.18	$38.02	$44.67
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $158.49 / $223.87	Professional	TC	$117.49	$158.49	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $186.21 / $275.42	Professional		$120.23	$186.21	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $144.54 / $229.09	Professional	TC	$93.33	$144.54	$229.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $281.84	Professional		$239.88	$281.84	$281.84
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $234.42 / $234.42	Professional	TC	$199.53	$234.42	$234.42