Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.41 / $26.41 / $26.41	Facility	26	$26.41	$26.41	$26.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.35 / $96.18 / $180.34	Professional		$92.35	$96.18	$180.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.67 / $28.36 / $75.65	Professional	26	$24.67	$28.36	$75.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.56 / $73.22 / $137.66	Professional	TC	$66.56	$73.22	$137.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.92 / $250.55 / $313.19	Professional		$163.92	$250.55	$313.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.06 / $58.18 / $72.72	Professional	26	$38.06	$58.18	$72.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.86 / $192.37 / $240.47	Professional	TC	$125.86	$192.37	$240.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.06 / $198.66 / $692.04	Professional		$104.06	$198.66	$692.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.44 / $50.82 / $165.29	Professional	26	$29.44	$50.82	$165.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.54 / $140.49 / $526.74	Professional	TC	$74.54	$140.49	$526.74
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $106.88 / $106.88 / $106.88	Facility	26	$106.88	$106.88	$106.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $180.79 / $248.48 / $272.62	Professional		$180.79	$248.48	$272.62
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $121.10 / $175.97 / $207.01	Professional		$121.10	$175.97	$207.01
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $42.34 / $49.81	Professional	26	$28.11	$42.34	$49.81
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.21 / $133.63 / $157.19	Professional	TC	$87.21	$133.63	$157.19
United Facility/Professional Professional Modifier Low / Median / High Price $115.85 / $189.20 / $212.64	Professional		$115.85	$189.20	$212.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $36.09 / $55.40	Professional	26	$28.15	$36.09	$55.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.28 / $104.96 / $161.82	Professional	TC	$80.28	$104.96	$161.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $189.70 / $223.20 / $223.20	Professional		$189.70	$223.20	$223.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $45.70 / $53.70 / $53.70	Professional	26	$45.70	$53.70	$53.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $144.10 / $169.50 / $169.50	Professional	TC	$144.10	$169.50	$169.50