Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.96 / $43.96 / $43.96	Facility	26	$43.96	$43.96	$43.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.46 / $123.72 / $384.30	Professional		$55.46	$123.72	$384.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $38.02 / $104.13	Professional	26	$26.28	$38.02	$104.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.81 / $89.34 / $209.15	Professional	TC	$9.81	$89.34	$209.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.23 / $122.56 / $153.19	Professional		$100.23	$122.56	$153.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.95 / $97.74 / $122.17	Professional	26	$63.95	$97.74	$122.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $24.82 / $47.53	Professional	TC	$20.30	$24.82	$47.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $94.02 / $144.94 / $558.63	Professional		$94.02	$144.94	$558.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.09 / $58.57 / $260.82	Professional	26	$34.09	$58.57	$260.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $56.03 / $101.06 / $430.88	Professional	TC	$56.03	$101.06	$430.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $96.74 / $96.74 / $96.74	Facility	26	$96.74	$96.74	$96.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.85 / $181.13 / $228.35	Professional		$113.85	$181.13	$228.35
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $102.06 / $191.96	Professional		$73.81	$102.06	$191.96
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.76 / $61.73 / $82.80	Professional	26	$38.76	$61.73	$82.80
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $15.13 / $20.70 / $140.54	Professional	TC	$15.13	$20.70	$140.54
United Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $141.03 / $239.44	Professional		$64.31	$141.03	$239.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.82 / $51.13 / $86.73	Professional	26	$34.82	$51.13	$86.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $84.04 / $176.14	Professional	TC	$13.18	$84.04	$176.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.90 / $111.60 / $111.60	Professional		$94.90	$111.60	$111.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $75.90 / $89.30 / $89.30	Professional	26	$75.90	$89.30	$89.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $22.30 / $22.30	Professional	TC	$19.00	$22.30	$22.30