Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.68 / $31.68 / $31.68	Facility	26	$31.68	$31.68	$31.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.48 / $123.13 / $504.90	Professional		$77.48	$123.13	$504.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.19 / $47.77 / $113.03	Professional	26	$29.19	$47.77	$113.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.57 / $92.18 / $443.22	Professional	TC	$49.57	$92.18	$443.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.32 / $188.50 / $235.62	Professional		$123.32	$188.50	$235.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.18 / $70.59 / $88.24	Professional	26	$46.18	$70.59	$88.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.14 / $117.91 / $147.38	Professional	TC	$77.14	$117.91	$147.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.77 / $156.55 / $524.64	Professional		$85.77	$156.55	$524.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $60.16 / $195.35	Professional	26	$36.15	$60.16	$195.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $58.19 / $96.39 / $329.23	Professional	TC	$58.19	$96.39	$329.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $100.58 / $100.58 / $100.58	Facility	26	$100.58	$100.58	$100.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $152.00 / $181.78 / $207.77	Professional		$152.00	$181.78	$207.77
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $102.96 / $137.31 / $156.55	Professional		$102.96	$137.31	$156.55
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.94 / $52.20 / $59.51	Professional	26	$38.94	$52.20	$59.51
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $60.69 / $84.13 / $97.04	Professional	TC	$60.69	$84.13	$97.04
United Facility/Professional Professional Modifier Low / Median / High Price $94.35 / $152.32 / $171.54	Professional		$94.35	$152.32	$171.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $43.02 / $65.73	Professional	26	$33.32	$43.02	$65.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.19 / $68.83 / $105.80	Professional	TC	$58.19	$68.83	$105.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $143.50 / $168.80 / $168.80	Professional		$143.50	$168.80	$168.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $54.50 / $64.20 / $64.20	Professional	26	$54.50	$64.20	$64.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $88.90 / $104.60 / $104.60	Professional	TC	$88.90	$104.60	$104.60