Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.01 / $50.01 / $50.01	Facility		$50.01	$50.01	$50.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.40 / $31.40 / $31.40	Facility	26	$31.40	$31.40	$31.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.01 / $90.20 / $307.05	Professional		$50.01	$90.20	$307.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $48.42 / $176.22	Professional	26	$27.08	$48.42	$176.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $41.78 / $60.50	Professional	TC	$16.17	$41.78	$60.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.61 / $110.93 / $138.66	Professional		$84.61	$110.93	$138.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $69.81 / $87.27	Professional	26	$48.28	$69.81	$87.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $41.11 / $51.39	Professional	TC	$33.61	$41.11	$51.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.79 / $86.50 / $192.03	Facility		$68.79	$86.50	$192.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.98 / $112.31 / $659.45	Professional		$63.98	$112.31	$659.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.27 / $64.34 / $335.18	Professional	26	$38.27	$64.34	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $47.96 / $404.98	Professional	TC	$25.71	$47.96	$404.98
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.47 / $113.56 / $181.55	Facility		$95.47	$113.56	$181.55
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $170.58 / $170.58 / $170.58	Facility	26	$170.58	$170.58	$170.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $101.77 / $138.53 / $189.54	Professional		$101.77	$138.53	$189.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $92.51 / $152.01	Professional		$65.34	$92.51	$152.01
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $41.12 / $57.05 / $87.03	Professional	26	$41.12	$57.05	$87.03
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.22 / $34.29 / $65.26	Professional	TC	$24.22	$34.29	$65.26
United Facility/Professional Professional Modifier Low / Median / High Price $57.52 / $98.64 / $187.18	Professional		$57.52	$98.64	$187.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.96 / $57.41 / $107.24	Professional	26	$35.96	$57.41	$107.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.56 / $38.57 / $79.94	Professional	TC	$21.56	$38.57	$79.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $84.80 / $99.70 / $99.70	Professional		$84.80	$99.70	$99.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $53.40 / $62.80 / $62.80	Professional	26	$53.40	$62.80	$62.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $31.40 / $37.00 / $37.00	Professional	TC	$31.40	$37.00	$37.00