Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.15 / $33.15 / $33.15	Facility	26	$33.15	$33.15	$33.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.78 / $87.51 / $124.27	Professional		$67.78	$87.51	$124.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.59 / $33.15 / $50.93	Professional	26	$28.59	$33.15	$50.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.19 / $55.88 / $80.95	Professional	TC	$39.19	$55.88	$80.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.33 / $174.53 / $218.17	Professional		$115.33	$174.53	$218.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.96 / $74.47 / $93.08	Professional	26	$48.96	$74.47	$93.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.12 / $100.07 / $125.08	Professional	TC	$66.12	$100.07	$125.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.41 / $186.78 / $583.91	Professional		$101.41	$186.78	$583.91
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $67.68 / $335.18	Professional	26	$36.81	$67.68	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $64.59 / $119.10 / $353.01	Professional	TC	$64.59	$119.10	$353.01
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $111.61 / $111.61 / $111.61	Facility	26	$111.61	$111.61	$111.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $158.00 / $184.37 / $221.35	Professional		$158.00	$184.37	$221.35
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $97.22 / $126.53 / $157.97	Professional		$97.22	$126.53	$157.97
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.04 / $54.47 / $62.10	Professional	26	$39.04	$54.47	$62.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $56.94 / $72.52 / $98.05	Professional	TC	$56.94	$72.52	$98.05
United Facility/Professional Professional Modifier Low / Median / High Price $89.88 / $150.22 / $192.22	Professional		$89.88	$150.22	$192.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.94 / $44.17 / $72.06	Professional	26	$37.94	$44.17	$72.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.94 / $78.17 / $120.16	Professional	TC	$51.94	$78.17	$120.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $132.19 / $155.50 / $155.50	Professional		$132.19	$155.50	$155.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $56.90 / $67.00 / $67.00	Professional	26	$56.90	$67.00	$67.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $75.30 / $88.60 / $88.60	Professional	TC	$75.30	$88.60	$88.60