Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.42 / $37.42 / $37.42	Facility	26	$37.42	$37.42	$37.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.33 / $91.23 / $142.22	Professional		$82.33	$91.23	$142.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.35 / $58.96 / $151.30	Professional	26	$35.35	$58.96	$151.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.58 / $85.82 / $433.43	Professional	TC	$48.58	$85.82	$433.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.94 / $200.13 / $250.16	Professional		$130.94	$200.13	$250.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.81 / $83.78 / $104.72	Professional	26	$54.81	$83.78	$104.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.13 / $116.36 / $145.44	Professional	TC	$76.13	$116.36	$145.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.42 / $161.88 / $555.44	Professional		$88.42	$161.88	$555.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.18 / $71.50 / $269.13	Professional	26	$43.18	$71.50	$269.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.00 / $90.39 / $351.46	Professional	TC	$57.00	$90.39	$351.46
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $122.80 / $122.80 / $122.80	Facility	26	$122.80	$122.80	$122.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $183.00 / $213.78	Professional		$161.63	$183.00	$213.78
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $105.94 / $145.82 / $166.25	Professional		$105.94	$145.82	$166.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.06 / $61.28 / $69.87	Professional	26	$46.06	$61.28	$69.87
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $59.64 / $81.94 / $96.39	Professional	TC	$59.64	$81.94	$96.39
United Facility/Professional Professional Modifier Low / Median / High Price $100.18 / $161.88 / $197.67	Professional		$100.18	$161.88	$197.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $48.88 / $78.50	Professional	26	$38.47	$48.88	$78.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.00 / $87.95 / $110.46	Professional	TC	$57.00	$87.95	$110.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $152.40 / $179.30 / $179.30	Professional		$152.40	$179.30	$179.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $64.00 / $75.30 / $75.30	Professional	26	$64.00	$75.30	$75.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $88.30 / $103.90 / $103.90	Professional	TC	$88.30	$103.90	$103.90