Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.54 / $35.54 / $35.54	Facility	26	$35.54	$35.54	$35.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.36 / $115.47 / $234.96	Professional		$92.36	$115.47	$234.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.67 / $37.54 / $121.93	Professional	26	$32.67	$37.54	$121.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.91 / $73.38 / $234.96	Professional	TC	$61.91	$73.38	$234.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.31 / $238.92 / $298.64	Professional		$156.31	$238.92	$298.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.77 / $79.12 / $98.90	Professional	26	$51.77	$79.12	$98.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.55 / $159.79 / $199.74	Professional	TC	$104.55	$159.79	$199.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.99 / $199.95 / $667.61	Professional		$108.99	$199.95	$667.61
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $67.51 / $219.03	Professional	26	$40.11	$67.51	$219.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.09 / $132.44 / $448.58	Professional	TC	$79.09	$132.44	$448.58
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $121.85 / $121.85 / $121.85	Facility	26	$121.85	$121.85	$121.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $198.54 / $239.10 / $263.02	Professional		$198.54	$239.10	$263.02
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $173.62 / $197.95	Professional		$130.63	$173.62	$197.95
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $44.78 / $59.01 / $67.28	Professional	26	$44.78	$59.01	$67.28
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $86.24 / $114.61 / $131.22	Professional	TC	$86.24	$114.61	$131.22
United Facility/Professional Professional Modifier Low / Median / High Price $119.21 / $142.44 / $216.74	Professional		$119.21	$142.44	$216.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $60.96 / $72.92	Professional	26	$40.11	$60.96	$72.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.09 / $107.87 / $143.82	Professional	TC	$79.09	$107.87	$143.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $181.40 / $213.40 / $213.40	Professional		$181.40	$213.40	$213.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $61.70 / $72.50 / $72.50	Professional	26	$61.70	$72.50	$72.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $119.80 / $140.90 / $140.90	Professional	TC	$119.80	$140.90	$140.90