Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.34 / $38.34 / $38.34	Facility	26	$38.34	$38.34	$38.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.34 / $92.40 / $130.59	Professional		$70.34	$92.40	$130.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $37.09 / $171.00	Professional	26	$33.35	$37.09	$171.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $56.22 / $81.47	Professional	TC	$36.97	$56.22	$81.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.99 / $184.62 / $230.77	Professional		$147.99	$184.62	$230.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.78 / $85.33 / $106.66	Professional	26	$69.78	$85.33	$106.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.61 / $99.29 / $124.11	Professional	TC	$65.61	$99.29	$124.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.43 / $133.00 / $1,002.61	Professional		$85.43	$133.00	$1,002.61
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.57 / $73.34 / $238.39	Professional	26	$47.57	$73.34	$238.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $37.63 / $59.66 / $780.59	Professional	TC	$37.63	$59.66	$780.59
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $125.06 / $125.06 / $125.06	Facility	26	$125.06	$125.06	$125.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $146.26 / $160.13 / $192.16	Professional		$146.26	$160.13	$192.16
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $126.43 / $153.96	Professional		$87.00	$126.43	$153.96
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.06 / $63.55 / $72.45	Professional	26	$48.06	$63.55	$72.45
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $65.34 / $81.51	Professional	TC	$38.90	$65.34	$81.51
United Facility/Professional Professional Modifier Low / Median / High Price $86.27 / $129.40 / $149.19	Professional		$86.27	$129.40	$149.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.74 / $71.34 / $84.74	Professional	26	$44.74	$71.34	$84.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.70 / $59.66 / $67.67	Professional	TC	$38.70	$59.66	$67.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $135.90 / $159.90 / $159.90	Professional		$135.90	$159.90	$159.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $63.90 / $75.20 / $75.20	Professional	26	$63.90	$75.20	$75.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $71.90 / $84.60 / $84.60	Professional	TC	$71.90	$84.60	$84.60