Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $33.11 / $33.11	Facility	26	$33.11	$33.11	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $263.03	Professional		$95.50	$162.18	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $61.66 / $104.71	Professional	26	$31.62	$61.66	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $107.15 / $251.19	Professional	TC	$67.61	$107.15	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $251.19 / $316.23	Professional		$199.53	$251.19	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $75.86 / $95.50	Professional	26	$60.26	$75.86	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $173.78 / $218.78	Professional	TC	$141.25	$173.78	$218.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $194.98 / $691.83	Professional		$100.00	$194.98	$691.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $67.61 / $257.04	Professional	26	$40.74	$67.61	$257.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $141.25 / $478.63	Professional	TC	$77.62	$141.25	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $245.47 / $245.47	Professional		$204.17	$245.47	$245.47
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $79.43 / $79.43	Professional	26	$64.57	$79.43	$79.43
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $165.96 / $165.96	Professional	TC	$141.25	$165.96	$165.96
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $173.78 / $204.17	Professional		$123.03	$173.78	$204.17
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $53.70 / $63.10	Professional	26	$40.74	$53.70	$63.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $123.03 / $141.25	Professional	TC	$87.10	$123.03	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $251.19	Professional		$112.20	$165.96	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $53.70 / $77.62	Professional	26	$34.67	$53.70	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $114.82 / $186.21	Professional	TC	$77.62	$114.82	$186.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $218.78 / $218.78	Professional		$186.21	$218.78	$218.78
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $67.61 / $67.61	Professional	26	$57.54	$67.61	$67.61
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $151.36 / $151.36	Professional	TC	$128.82	$151.36	$151.36