Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.33 / $111.33 / $476.30	Facility		$111.33	$111.33	$476.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.90 / $15.90 / $15.90	Facility	26	$15.90	$15.90	$15.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.35 / $94.14 / $173.18	Professional		$91.35	$94.14	$173.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.75 / $23.96 / $57.60	Professional	26	$13.75	$23.96	$57.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.31 / $80.39 / $149.21	Professional	TC	$76.31	$80.39	$149.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.39 / $238.92 / $298.64	Professional		$195.39	$238.92	$298.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.55 / $34.90 / $43.63	Professional	26	$28.55	$34.90	$43.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.02 / $204.01 / $255.01	Professional	TC	$162.02	$204.01	$255.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.62 / $159.10 / $188.15	Facility		$112.62	$159.10	$188.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.70 / $172.73 / $687.89	Professional		$98.70	$172.73	$687.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.64 / $30.29 / $150.00	Professional	26	$19.64	$30.29	$150.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $78.98 / $138.22 / $591.79	Professional	TC	$78.98	$138.22	$591.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $156.19 / $202.16 / $344.16	Facility		$156.19	$202.16	$344.16
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $52.11 / $52.11 / $52.11	Facility	26	$52.11	$52.11	$52.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $139.00 / $200.30 / $263.02	Professional		$139.00	$200.30	$263.02
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $99.48 / $146.62 / $196.66	Professional		$99.48	$146.62	$196.66
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $26.10 / $29.76	Professional	26	$19.73	$26.10	$29.76
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $79.25 / $124.43 / $166.90	Professional	TC	$79.25	$124.43	$166.90
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.82 / $182.10	Professional		$107.15	$144.82	$182.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $26.29 / $33.29	Professional	26	$18.37	$26.29	$33.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.75 / $131.63 / $157.82	Professional	TC	$94.75	$131.63	$157.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.60 / $204.20 / $204.20	Professional		$173.60	$204.20	$204.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.90 / $30.90	Professional	26	$26.30	$30.90	$30.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $147.30 / $173.30 / $173.30	Professional	TC	$147.30	$173.30	$173.30