Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.12 / $46.12 / $46.12	Facility	26	$46.12	$46.12	$46.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.86 / $163.13 / $234.33	Professional		$85.86	$163.13	$234.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $24.17 / $199.80	Professional	26	$16.71	$24.17	$199.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.16 / $146.43 / $212.38	Professional	TC	$46.16	$146.43	$212.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.80 / $221.07 / $276.33	Professional		$180.80	$221.07	$276.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.98 / $102.39 / $127.99	Professional	26	$66.98	$102.39	$127.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.06 / $118.68 / $148.35	Professional	TC	$97.06	$118.68	$148.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $182.07 / $2,899.89	Professional		$104.04	$182.07	$2,899.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.75 / $55.85 / $425.60	Professional	26	$20.75	$55.85	$425.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $71.62 / $110.41 / $2,808.09	Professional	TC	$71.62	$110.41	$2,808.09
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $56.60 / $56.60 / $56.60	Facility	26	$56.60	$56.60	$56.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $180.68 / $202.36 / $484.37	Professional		$180.68	$202.36	$484.37
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $105.97 / $157.82 / $185.66	Professional		$105.97	$157.82	$185.66
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $65.59 / $87.98	Professional	26	$21.88	$65.59	$87.98
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $72.83 / $97.62 / $129.38	Professional	TC	$72.83	$97.62	$129.38
United Facility/Professional Professional Modifier Low / Median / High Price $113.00 / $161.22 / $198.75	Professional		$113.00	$161.22	$198.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.94 / $54.32 / $88.34	Professional	26	$25.94	$54.32	$88.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.12 / $104.11 / $145.76	Professional	TC	$61.12	$104.11	$145.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $163.90 / $192.80 / $192.80	Professional		$163.90	$192.80	$192.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $77.59 / $91.40 / $91.40	Professional	26	$77.59	$91.40	$91.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $101.40 / $101.40	Professional	TC	$86.20	$101.40	$101.40