Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.50 / $493.27 / $734.32	Facility		$145.50	$493.27	$734.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.08 / $33.08 / $33.08	Facility	26	$33.08	$33.08	$33.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.13 / $89.00 / $185.12	Professional		$31.13	$89.00	$185.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.97 / $35.90 / $89.89	Professional	26	$29.97	$35.90	$89.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.09 / $200.00 / $672.00	Professional	50	$72.09	$200.00	$672.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.58 / $80.98 / $378.90	Professional	TC	$50.58	$80.98	$378.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.41 / $197.80 / $247.25	Professional		$129.41	$197.80	$247.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.21 / $73.69 / $92.11	Professional	26	$48.21	$73.69	$92.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.20 / $124.11 / $155.13	Professional	TC	$81.20	$124.11	$155.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.12 / $138.68 / $319.08	Facility		$107.12	$138.68	$319.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.14 / $158.81 / $546.22	Professional		$89.14	$158.81	$546.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.33 / $62.83 / $122.42	Professional	26	$37.33	$62.83	$122.42
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $334.14 / $334.14 / $334.14	Professional	50	$334.14	$334.14	$334.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.57 / $100.40 / $342.28	Professional	TC	$60.57	$100.40	$342.28
Midlands Facility/Professional Facility Modifier Low / Median / High Price $166.64 / $195.73 / $287.56	Facility		$166.64	$195.73	$287.56
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $113.72 / $113.72 / $113.72	Facility	26	$113.72	$113.72	$113.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $163.51 / $195.73 / $217.38	Professional		$163.51	$195.73	$217.38
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $107.62 / $144.12 / $164.31	Professional		$107.62	$144.12	$164.31
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $41.77 / $55.04 / $62.75	Professional	26	$41.77	$55.04	$62.75
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $66.06 / $89.08 / $101.56	Professional	TC	$66.06	$89.08	$101.56
United Facility/Professional Professional Modifier Low / Median / High Price $100.27 / $163.22 / $237.22	Professional		$100.27	$163.22	$237.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.33 / $50.91 / $67.88	Professional	26	$37.33	$50.91	$67.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.27 / $97.68 / $120.21	Professional	TC	$61.27	$97.68	$120.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.60 / $177.20 / $177.20	Professional		$150.60	$177.20	$177.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $67.70 / $67.70	Professional	26	$57.50	$67.70	$67.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $93.10 / $109.50 / $109.50	Professional	TC	$93.10	$109.50	$109.50