Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	26	$30.90	$30.90	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $147.91 / $263.03	Professional		$77.62	$147.91	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $66.07 / $102.33	Professional	26	$30.20	$66.07	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $91.20 / $446.68	Professional	TC	$47.86	$91.20	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $194.98 / $239.88	Professional		$154.88	$194.98	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $91.20	Professional	26	$57.54	$72.44	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $120.23 / $151.36	Professional	TC	$95.50	$120.23	$151.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $151.36 / $524.81	Professional		$77.62	$151.36	$524.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $64.57 / $194.98	Professional	26	$33.11	$64.57	$194.98
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $104.71 / $331.13	Professional	TC	$52.48	$104.71	$331.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $190.55 / $190.55	Professional		$158.49	$190.55	$190.55
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $75.86 / $75.86	Professional	26	$61.66	$75.86	$75.86
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $112.20 / $112.20	Professional	TC	$97.72	$112.20	$112.20
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $154.88	Professional		$102.33	$131.83	$154.88
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $58.88	Professional	26	$38.02	$50.12	$58.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $83.18 / $97.72	Professional	TC	$60.26	$83.18	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $186.21	Professional		$87.10	$128.82	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $50.12 / $70.79	Professional	26	$32.36	$50.12	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $79.43 / $123.03	Professional	TC	$53.70	$79.43	$123.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $169.82 / $169.82	Professional		$144.54	$169.82	$169.82
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $64.57 / $64.57	Professional	26	$54.95	$64.57	$64.57
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $104.71 / $104.71	Professional	TC	$89.13	$104.71	$104.71