Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.17 / $48.17 / $48.17	Facility	26	$48.17	$48.17	$48.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.69 / $129.90 / $193.66	Professional		$105.69	$129.90	$193.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.68 / $72.81 / $168.21	Professional	26	$44.68	$72.81	$168.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.43 / $188.10 / $299.86	Professional	TC	$72.43	$188.10	$299.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.13 / $272.27 / $340.34	Professional		$178.13	$272.27	$340.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.04 / $107.05 / $133.81	Professional	26	$70.04	$107.05	$133.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.10 / $165.22 / $206.53	Professional	TC	$108.10	$165.22	$206.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.81 / $227.81 / $757.96	Professional		$124.81	$227.81	$757.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $55.02 / $92.04 / $312.14	Professional	26	$55.02	$92.04	$312.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $82.27 / $135.77 / $470.82	Professional	TC	$82.27	$135.77	$470.82
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $155.78 / $155.78 / $155.78	Facility	26	$155.78	$155.78	$155.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $172.00 / $254.54 / $300.25	Professional		$172.00	$254.54	$300.25
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $137.49 / $198.02 / $225.77	Professional		$137.49	$198.02	$225.77
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.62 / $79.44 / $90.57	Professional	26	$58.62	$79.44	$90.57
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $83.69 / $118.59 / $135.19	Professional	TC	$83.69	$118.59	$135.19
United Facility/Professional Professional Modifier Low / Median / High Price $137.29 / $162.75 / $249.62	Professional		$137.29	$162.75	$249.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.02 / $62.88 / $100.04	Professional	26	$55.02	$62.88	$100.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.27 / $89.52 / $149.58	Professional	TC	$82.27	$89.52	$149.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $206.90 / $243.40 / $243.40	Professional		$206.90	$243.40	$243.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $83.00 / $97.60 / $97.60	Professional	26	$83.00	$97.60	$97.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $123.90 / $145.80 / $145.80	Professional	TC	$123.90	$145.80	$145.80