Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.87 / $64.87 / $64.87	Facility	26	$64.87	$64.87	$64.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.69 / $216.53 / $306.79	Professional		$110.69	$216.53	$306.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.85 / $58.13 / $216.00	Professional	26	$52.85	$58.13	$216.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.34 / $163.68 / $237.43	Professional	TC	$54.34	$163.68	$237.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.55 / $283.13 / $353.91	Professional		$231.55	$283.13	$353.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.99 / $144.28 / $180.35	Professional	26	$117.99	$144.28	$180.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.55 / $138.85 / $173.56	Professional	TC	$113.55	$138.85	$173.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $163.44 / $253.71 / $3,098.01	Professional		$163.44	$253.71	$3,098.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.09 / $113.90 / $636.41	Professional	26	$65.09	$113.90	$636.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.32 / $128.44 / $2,808.09	Professional	TC	$83.32	$128.44	$2,808.09
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $181.32 / $181.32 / $181.32	Facility	26	$181.32	$181.32	$181.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $262.52 / $292.67 / $606.28	Professional		$262.52	$292.67	$606.28
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $167.10 / $224.22 / $243.23	Professional		$167.10	$224.22	$243.23
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $68.47 / $96.46 / $129.38	Professional	26	$68.47	$96.46	$129.38
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $84.88 / $113.85 / $156.02	Professional	TC	$84.88	$113.85	$156.02
United Facility/Professional Professional Modifier Low / Median / High Price $151.38 / $217.94 / $286.04	Professional		$151.38	$217.94	$286.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.09 / $108.48 / $125.26	Professional	26	$79.09	$108.48	$125.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.90 / $124.97 / $172.14	Professional	TC	$71.90	$124.97	$172.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $214.70 / $252.60 / $252.60	Professional		$214.70	$252.60	$252.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.20 / $134.30 / $134.30	Professional	26	$114.20	$134.30	$134.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $100.50 / $118.20 / $118.20	Professional	TC	$100.50	$118.20	$118.20