Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.53 / $48.53 / $48.53	Facility	26	$48.53	$48.53	$48.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.83 / $144.69 / $219.91	Professional		$128.83	$144.69	$219.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.13 / $114.81 / $202.92	Professional	26	$45.13	$114.81	$202.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.62 / $237.60 / $691.53	Professional	TC	$90.62	$237.60	$691.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.54 / $314.16 / $392.70	Professional		$205.54	$314.16	$392.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.54 / $107.82 / $134.78	Professional	26	$70.54	$107.82	$134.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.00 / $206.34 / $257.92	Professional	TC	$135.00	$206.34	$257.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.97 / $261.20 / $872.98	Professional		$143.97	$261.20	$872.98
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $55.18 / $92.04 / $298.50	Professional	26	$55.18	$92.04	$298.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $103.19 / $169.16 / $574.48	Professional	TC	$103.19	$169.16	$574.48
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $158.24 / $158.24 / $158.24	Facility	26	$158.24	$158.24	$158.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $233.00 / $293.63 / $345.88	Professional		$233.00	$293.63	$345.88
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $159.97 / $228.09 / $260.05	Professional		$159.97	$228.09	$260.05
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.62 / $80.00 / $91.21	Professional	26	$58.62	$80.00	$91.21
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $108.93 / $148.09 / $169.25	Professional	TC	$108.93	$148.09	$169.25
United Facility/Professional Professional Modifier Low / Median / High Price $150.01 / $189.19 / $287.94	Professional		$150.01	$189.19	$287.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.26 / $65.70 / $103.64	Professional	26	$51.26	$65.70	$103.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.19 / $164.59 / $194.29	Professional	TC	$103.19	$164.59	$194.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $238.30 / $280.39 / $280.39	Professional		$238.30	$280.39	$280.39
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $83.60 / $98.30 / $98.30	Professional	26	$83.60	$98.30	$98.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $154.69 / $182.00 / $182.00	Professional	TC	$154.69	$182.00	$182.00