Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.52 / $28.52 / $28.52	Facility	26	$28.52	$28.52	$28.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.43 / $106.73 / $117.41	Professional		$80.43	$106.73	$117.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.16 / $74.03 / $86.27	Professional	TC	$56.16	$74.03	$86.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.74 / $206.34 / $257.92	Professional		$168.74	$206.34	$257.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.36 / $143.50 / $179.38	Professional	TC	$117.36	$143.50	$179.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.98 / $181.08 / $673.71	Professional		$109.98	$181.08	$673.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $72.53 / $121.06 / $514.25	Professional	TC	$72.53	$121.06	$514.25
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $100.52 / $100.52 / $100.52	Facility	26	$100.52	$100.52	$100.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $139.00 / $201.15 / $224.58	Professional		$139.00	$201.15	$224.58
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $111.54 / $149.79 / $171.15	Professional		$111.54	$149.79	$171.15
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $37.02 / $46.53 / $53.25	Professional	26	$37.02	$46.53	$53.25
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $72.52 / $100.08 / $117.91	Professional	TC	$72.52	$100.08	$117.91
United Facility/Professional Professional Modifier Low / Median / High Price $107.05 / $145.19 / $183.30	Professional		$107.05	$145.19	$183.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.29 / $97.79 / $124.43	Professional	TC	$74.29	$97.79	$124.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.69 / $177.30 / $177.30	Professional		$150.69	$177.30	$177.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $103.90 / $122.20 / $122.20	Professional	TC	$103.90	$122.20	$122.20