Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.43 / $33.43 / $33.43	Facility	26	$33.43	$33.43	$33.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.97 / $125.82 / $180.02	Professional		$94.97	$125.82	$180.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.91 / $49.09 / $115.70	Professional	26	$30.91	$49.09	$115.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.88 / $120.40 / $252.00	Professional	TC	$69.88	$120.40	$252.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.88 / $245.90 / $307.37	Professional		$160.88	$245.90	$307.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.72 / $74.47 / $93.08	Professional	26	$48.72	$74.47	$93.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.16 / $171.43 / $214.29	Professional	TC	$112.16	$171.43	$214.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.52 / $204.61 / $687.27	Professional		$111.52	$204.61	$687.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.13 / $63.49 / $254.27	Professional	26	$38.13	$63.49	$254.27
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $84.63 / $141.12 / $479.00	Professional	TC	$84.63	$141.12	$479.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $109.13 / $109.13 / $109.13	Facility	26	$109.13	$109.13	$109.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $242.40 / $271.37	Professional		$169.00	$242.40	$271.37
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $132.47 / $178.16 / $203.13	Professional		$132.47	$178.16	$203.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $41.04 / $55.04 / $62.75	Professional	26	$41.04	$55.04	$62.75
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $91.25 / $123.13 / $140.38	Professional	TC	$91.25	$123.13	$140.38
United Facility/Professional Professional Modifier Low / Median / High Price $122.76 / $178.56 / $223.20	Professional		$122.76	$178.56	$223.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.13 / $61.78 / $88.86	Professional	26	$38.13	$61.78	$88.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.55 / $110.91 / $153.88	Professional	TC	$80.55	$110.91	$153.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.20 / $219.00 / $219.00	Professional		$186.20	$219.00	$219.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $67.70 / $67.70	Professional	26	$57.50	$67.70	$67.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $128.69 / $151.40 / $151.40	Professional	TC	$128.69	$151.40	$151.40