Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.17 / $28.17 / $28.17	Facility	26	$28.17	$28.17	$28.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $80.83 / $171.78	Professional		$73.48	$80.83	$171.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.24 / $25.35 / $42.49	Professional	26	$24.24	$25.35	$42.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.13 / $52.94 / $129.28	Professional	TC	$48.13	$52.94	$129.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.02 / $239.69 / $299.61	Professional		$196.02	$239.69	$299.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $62.83 / $78.54	Professional	26	$51.38	$62.83	$78.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.68 / $176.86 / $221.07	Professional	TC	$134.68	$176.86	$221.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.69 / $195.27 / $659.39	Professional		$121.69	$195.27	$659.39
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $53.49 / $173.89	Professional	26	$34.54	$53.49	$173.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $87.15 / $141.78 / $485.50	Professional	TC	$87.15	$141.78	$485.50
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $88.47 / $88.47 / $88.47	Facility	26	$88.47	$88.47	$88.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.89 / $201.74 / $281.02	Professional		$102.89	$201.74	$281.02
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $121.00 / $168.27 / $197.95	Professional		$121.00	$168.27	$197.95
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.18 / $46.85 / $53.05	Professional	26	$35.18	$46.85	$53.05
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.42 / $123.18 / $144.91	Professional	TC	$87.42	$123.18	$144.91
United Facility/Professional Professional Modifier Low / Median / High Price $122.63 / $189.99 / $212.96	Professional		$122.63	$189.99	$212.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.35 / $52.04 / $60.44	Professional	26	$32.35	$52.04	$60.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.48 / $137.94 / $153.22	Professional	TC	$80.48	$137.94	$153.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $196.40 / $231.00 / $231.00	Professional		$196.40	$231.00	$231.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $52.60 / $61.90 / $61.90	Professional	26	$52.60	$61.90	$61.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $143.80 / $169.10 / $169.10	Professional	TC	$143.80	$169.10	$169.10