Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.59 / $36.59 / $36.59	Facility	26	$36.59	$36.59	$36.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.77 / $156.66 / $218.58	Professional		$132.77	$156.66	$218.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.36 / $38.01 / $128.69	Professional	26	$31.36	$38.01	$128.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.41 / $120.09 / $171.99	Professional	TC	$101.41	$120.09	$171.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.82 / $343.64 / $429.54	Professional		$224.82	$343.64	$429.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.29 / $81.45 / $101.81	Professional	26	$53.29	$81.45	$101.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.54 / $262.19 / $327.73	Professional	TC	$171.54	$262.19	$327.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $159.16 / $291.49 / $968.58	Professional		$159.16	$291.49	$968.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.34 / $70.67 / $227.63	Professional	26	$39.34	$70.67	$227.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $121.09 / $220.82 / $740.95	Professional	TC	$121.09	$220.82	$740.95
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $120.19 / $120.19 / $120.19	Facility	26	$120.19	$120.19	$120.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $250.49 / $311.70 / $378.31	Professional		$250.49	$311.70	$378.31
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $189.65 / $248.52 / $283.33	Professional		$189.65	$248.52	$283.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.34 / $60.71 / $69.22	Professional	26	$46.34	$60.71	$69.22
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $143.30 / $187.81 / $214.89	Professional	TC	$143.30	$187.81	$214.89
United Facility/Professional Professional Modifier Low / Median / High Price $174.88 / $209.27 / $411.80	Professional		$174.88	$209.27	$411.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.68 / $56.84 / $75.78	Professional	26	$41.68	$56.84	$75.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $159.91 / $242.18	Professional	TC	$123.03	$159.91	$242.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $259.70 / $305.50 / $305.50	Professional		$259.70	$305.50	$305.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $63.40 / $74.59 / $74.59	Professional	26	$63.40	$74.59	$74.59
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $196.20 / $230.90 / $230.90	Professional	TC	$196.20	$230.90	$230.90