Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Facility	26	$45.71	$45.71	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $239.88	Professional		$85.11	$123.03	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $46.77 / $117.49	Professional	26	$18.20	$46.77	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $63.10 / $169.82	Professional	TC	$45.71	$63.10	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $223.87 / $281.84	Professional		$181.97	$223.87	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $104.71 / $131.83	Professional	26	$67.61	$104.71	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $120.23 / $151.36	Professional	TC	$97.72	$120.23	$151.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $138.04 / $338.84	Professional		$93.33	$138.04	$338.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $37.15 / $426.58	Professional	26	$19.05	$37.15	$426.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $104.71 / $2,818.38	Professional	TC	$64.57	$104.71	$2,818.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $190.55 / $204.17	Professional		$181.97	$190.55	$204.17
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $91.20 / $97.72	Professional	26	$39.81	$91.20	$97.72
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $107.15 / $144.54	Professional	TC	$97.72	$107.15	$144.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	26	$100.00	$100.00	$100.00
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	TC	$120.23	$120.23	$120.23
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $186.21	Professional		$107.15	$158.49	$186.21
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $57.54 / $87.10	Professional	26	$22.91	$57.54	$87.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $97.72 / $138.04	Professional	TC	$69.18	$97.72	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $245.47	Professional		$102.33	$165.96	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $37.15 / $89.13	Professional	26	$19.05	$37.15	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $109.65 / $173.78	Professional	TC	$61.66	$109.65	$173.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $194.98	Professional		$162.18	$194.98	$194.98
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $91.20	Professional	26	$77.62	$91.20	$91.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $102.33 / $102.33	Professional	TC	$87.10	$102.33	$102.33