Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.91 / $45.91 / $45.91	Facility	26	$45.91	$45.91	$45.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.56 / $162.21 / $221.87	Professional		$120.56	$162.21	$221.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $44.68 / $69.17	Professional	26	$39.90	$44.68	$69.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.66 / $117.54 / $152.69	Professional	TC	$80.66	$117.54	$152.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.06 / $311.06 / $388.82	Professional		$247.06	$311.06	$388.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.74 / $102.39 / $127.99	Professional	26	$83.74	$102.39	$127.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $136.52 / $208.66 / $260.83	Professional	TC	$136.52	$208.66	$260.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.62 / $269.20 / $1,035.22	Professional		$174.62	$269.20	$1,035.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.96 / $89.36 / $287.12	Professional	26	$57.96	$89.36	$287.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.66 / $179.85 / $780.77	Professional	TC	$116.66	$179.85	$780.77
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $153.94 / $153.94 / $153.94	Facility	26	$153.94	$153.94	$153.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $247.06 / $260.98 / $338.07	Professional		$247.06	$260.98	$338.07
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $176.34 / $235.09 / $258.63	Professional		$176.34	$235.09	$258.63
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $59.64 / $76.03 / $86.68	Professional	26	$59.64	$76.03	$86.68
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $116.70 / $155.58 / $173.68	Professional	TC	$116.70	$155.58	$173.68
United Facility/Professional Professional Modifier Low / Median / High Price $160.58 / $269.20 / $307.31	Professional		$160.58	$269.20	$307.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.53 / $86.94 / $103.44	Professional	26	$53.53	$86.94	$103.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.05 / $175.00 / $204.54	Professional	TC	$107.05	$175.00	$204.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $255.40 / $300.50 / $300.50	Professional		$255.40	$300.50	$300.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $86.00 / $101.20 / $101.20	Professional	26	$86.00	$101.20	$101.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $169.40 / $199.30 / $199.30	Professional	TC	$169.40	$199.30	$199.30