Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.63 / $41.63 / $41.63	Facility	26	$41.63	$41.63	$41.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.15 / $115.73 / $627.45	Professional		$103.15	$115.73	$627.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $64.63 / $146.85	Professional	26	$38.81	$64.63	$146.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.31 / $184.50 / $495.90	Professional	TC	$64.31	$184.50	$495.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.97 / $255.21 / $319.01	Professional		$166.97	$255.21	$319.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.90 / $93.08 / $116.36	Professional	26	$60.90	$93.08	$116.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.07 / $162.12 / $202.65	Professional	TC	$106.07	$162.12	$202.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $211.29 / $708.49	Professional		$115.13	$211.29	$708.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.07 / $78.84 / $257.68	Professional	26	$48.07	$78.84	$257.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $80.69 / $132.44 / $450.80	Professional	TC	$80.69	$132.44	$450.80
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $136.77 / $136.77 / $136.77	Facility	26	$136.77	$136.77	$136.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $233.98 / $280.43	Professional		$131.00	$233.98	$280.43
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $126.83 / $184.41 / $210.24	Professional		$126.83	$184.41	$210.24
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.42 / $68.09 / $77.63	Professional	26	$43.42	$68.09	$77.63
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $82.52 / $116.32 / $132.61	Professional	TC	$82.52	$116.32	$132.61
United Facility/Professional Professional Modifier Low / Median / High Price $128.76 / $153.75 / $234.10	Professional		$128.76	$153.75	$234.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $66.34 / $111.09	Professional	26	$47.94	$66.34	$111.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.81 / $104.10 / $194.78	Professional	TC	$71.81	$104.10	$194.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $192.70 / $226.70 / $226.70	Professional		$192.70	$226.70	$226.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $71.09 / $83.70 / $83.70	Professional	26	$71.09	$83.70	$83.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $121.50 / $143.00 / $143.00	Professional	TC	$121.50	$143.00	$143.00