Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $378.11 / $716.01 / $927.90	Facility		$378.11	$716.01	$927.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.52 / $28.52 / $28.52	Facility	26	$28.52	$28.52	$28.52
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $64.13 / $369.18 / $484.21	Facility	TC	$64.13	$369.18	$484.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.31 / $107.68 / $156.62	Professional		$78.31	$107.68	$156.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.24 / $35.36 / $99.90	Professional	26	$26.24	$35.36	$99.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.42 / $102.30 / $210.80	Professional	TC	$59.42	$102.30	$210.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.97 / $203.23 / $254.04	Professional		$132.97	$203.23	$254.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.62 / $63.61 / $79.51	Professional	26	$41.62	$63.61	$79.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.35 / $139.63 / $174.53	Professional	TC	$91.35	$139.63	$174.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.77 / $156.58 / $842.55	Facility		$126.77	$156.58	$842.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $92.75 / $169.90 / $568.24	Professional		$92.75	$169.90	$568.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.13 / $54.15 / $227.85	Professional	26	$35.13	$54.15	$227.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.23 / $115.75 / $390.02	Professional	TC	$69.23	$115.75	$390.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $163.09 / $202.59 / $294.35	Facility		$163.09	$202.59	$294.35
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $93.96 / $93.96 / $93.96	Facility	26	$93.96	$93.96	$93.96
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $260.94 / $260.94 / $260.94	Facility	TC	$260.94	$260.94	$260.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $202.59 / $225.57	Professional		$153.00	$202.59	$225.57
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $102.55 / $147.52 / $168.19	Professional		$102.55	$147.52	$168.19
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.17 / $47.09 / $53.69	Professional	26	$35.17	$47.09	$53.69
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $70.33 / $100.43 / $114.74	Professional	TC	$70.33	$100.43	$114.74
United Facility/Professional Professional Modifier Low / Median / High Price $101.68 / $121.55 / $184.88	Professional		$101.68	$121.55	$184.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.03 / $45.57 / $63.56	Professional	26	$30.03	$45.57	$63.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.23 / $83.12 / $125.88	Professional	TC	$69.23	$83.12	$125.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $154.10 / $181.30 / $181.30	Professional		$154.10	$181.30	$181.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $49.20 / $57.90 / $57.90	Professional	26	$49.20	$57.90	$57.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $104.90 / $123.50 / $123.50	Professional	TC	$104.90	$123.50	$123.50