Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.59 / $36.59 / $36.59	Facility	26	$36.59	$36.59	$36.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.15 / $141.91 / $258.99	Professional		$88.15	$141.91	$258.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $57.29 / $132.60	Professional	26	$34.04	$57.29	$132.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.47 / $89.30 / $455.40	Professional	TC	$54.47	$89.30	$455.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.58 / $214.87 / $268.58	Professional		$140.58	$214.87	$268.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.29 / $81.45 / $101.81	Professional	26	$53.29	$81.45	$101.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.29 / $133.41 / $166.78	Professional	TC	$87.29	$133.41	$166.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $178.58 / $600.27	Professional		$105.05	$178.58	$600.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.84 / $69.50 / $233.19	Professional	26	$41.84	$69.50	$233.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.48 / $109.08 / $372.64	Professional	TC	$66.48	$109.08	$372.64
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $118.96 / $118.96 / $118.96	Facility	26	$118.96	$118.96	$118.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $166.00 / $203.95 / $236.60	Professional		$166.00	$203.95	$236.60
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $112.05 / $156.04 / $177.90	Professional		$112.05	$156.04	$177.90
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $44.81 / $60.14 / $68.56	Professional	26	$44.81	$60.14	$68.56
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $67.58 / $95.89 / $109.33	Professional	TC	$67.58	$95.89	$109.33
United Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $129.32 / $206.79	Professional		$105.05	$129.32	$206.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.84 / $49.80 / $79.87	Professional	26	$41.84	$49.80	$79.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.48 / $79.79 / $120.88	Professional	TC	$66.48	$79.79	$120.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $163.00 / $191.80 / $191.80	Professional		$163.00	$191.80	$191.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $62.80 / $73.90 / $73.90	Professional	26	$62.80	$73.90	$73.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $100.20 / $117.90 / $117.90	Professional	TC	$100.20	$117.90	$117.90