Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.97 / $30.97 / $30.97	Facility	26	$30.97	$30.97	$30.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.13 / $125.23 / $180.25	Professional		$90.13	$125.23	$180.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $38.97 / $122.82	Professional	26	$28.51	$38.97	$122.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.39 / $191.70 / $206.10	Professional	TC	$80.39	$191.70	$206.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.27 / $234.26 / $292.83	Professional		$153.27	$234.26	$292.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.17 / $69.04 / $86.30	Professional	26	$45.17	$69.04	$86.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.10 / $165.22 / $206.53	Professional	TC	$108.10	$165.22	$206.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $147.36 / $654.87	Professional		$82.25	$147.36	$654.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $58.83 / $217.94	Professional	26	$35.36	$58.83	$217.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $43.67 / $88.93 / $461.63	Professional	TC	$43.67	$88.93	$461.63
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $102.19 / $102.19 / $102.19	Facility	26	$102.19	$102.19	$102.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $132.58 / $212.78 / $258.20	Professional		$132.58	$212.78	$258.20
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $144.21 / $193.42	Professional		$103.02	$144.21	$193.42
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.10 / $50.91 / $58.22	Professional	26	$38.10	$50.91	$58.22
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $56.63 / $102.83 / $135.19	Professional	TC	$56.63	$102.83	$135.19
United Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $127.09 / $195.93	Professional		$82.25	$127.09	$195.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.60 / $42.08 / $64.30	Professional	26	$32.60	$42.08	$64.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.22 / $89.22 / $137.10	Professional	TC	$58.22	$89.22	$137.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $177.30 / $208.60 / $208.60	Professional		$177.30	$208.60	$208.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $53.40 / $62.80 / $62.80	Professional	26	$53.40	$62.80	$62.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $123.90 / $145.80 / $145.80	Professional	TC	$123.90	$145.80	$145.80