Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.85 / $32.85 / $32.85	Facility	26	$32.85	$32.85	$32.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.45 / $141.34 / $250.90	Professional		$125.45	$141.34	$250.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.11 / $32.46 / $57.73	Professional	26	$27.11	$32.46	$57.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.75 / $99.56 / $189.78	Professional	TC	$96.75	$99.56	$189.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.99 / $464.64 / $580.80	Professional		$303.99	$464.64	$580.80
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 $247.40 / $390.18 / $487.72	Professional	TC	$247.40	$390.18	$487.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $206.94 / $898.89	Professional		$115.50	$206.94	$898.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.03 / $62.59 / $371.50	Professional	26	$37.03	$62.59	$371.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $75.11 / $150.43 / $695.99	Professional	TC	$75.11	$150.43	$695.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $109.83 / $109.83 / $109.83	Facility	26	$109.83	$109.83	$109.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $286.70 / $511.62	Professional		$169.00	$286.70	$511.62
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $261.70 / $381.02	Professional		$116.28	$261.70	$381.02
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.78 / $54.34 / $62.10	Professional	26	$39.78	$54.34	$62.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $75.37 / $220.47 / $318.92	Professional	TC	$75.37	$220.47	$318.92
United Facility/Professional Professional Modifier Low / Median / High Price $135.90 / $235.06 / $294.50	Professional		$135.90	$235.06	$294.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.42 / $43.90 / $67.31	Professional	26	$35.42	$43.90	$67.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.75 / $202.92 / $231.91	Professional	TC	$106.75	$202.92	$231.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $349.20 / $410.80 / $410.80	Professional		$349.20	$410.80	$410.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $56.90 / $67.00 / $67.00	Professional	26	$56.90	$67.00	$67.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $292.30 / $343.90 / $343.90	Professional	TC	$292.30	$343.90	$343.90