Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $36.31 / $36.31	Facility	26	$36.31	$36.31	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $186.21 / $257.04	Professional		$89.13	$186.21	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $67.61 / $97.72	Professional	26	$34.67	$67.61	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $87.10 / $229.09	Professional	TC	$54.95	$87.10	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $275.42	Professional		$173.78	$218.78	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $83.18 / $104.71	Professional	26	$66.07	$83.18	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $138.04 / $169.82	Professional	TC	$109.65	$138.04	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $602.56	Professional		$97.72	$177.83	$602.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $74.13 / $234.42	Professional	26	$41.69	$74.13	$234.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $120.23 / $371.54	Professional	TC	$60.26	$120.23	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $213.80	Professional		$181.97	$213.80	$213.80
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $87.10 / $87.10	Professional	26	$72.44	$87.10	$87.10
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $128.82 / $128.82	Professional	TC	$109.65	$128.82	$128.82
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $177.83	Professional		$112.20	$151.36	$177.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $58.88 / $69.18	Professional	26	$44.67	$58.88	$69.18
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $93.33 / $109.65	Professional	TC	$67.61	$93.33	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $213.80	Professional		$100.00	$147.91	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $58.88 / $81.28	Professional	26	$38.02	$58.88	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $91.20 / $134.90	Professional	TC	$61.66	$91.20	$134.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $190.55	Professional		$162.18	$190.55	$190.55
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $74.13 / $74.13	Professional	26	$63.10	$74.13	$74.13
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $117.49 / $117.49	Professional	TC	$100.00	$117.49	$117.49