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 $30.90 / $87.22 / $179.78	Professional		$30.90	$87.22	$179.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $69.30 / $147.60	Professional	26	$19.73	$69.30	$147.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.42 / $54.79 / $185.12	Professional	TC	$10.42	$54.79	$185.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $148.93 / $186.17	Professional		$97.44	$148.93	$186.17
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 $48.72 / $74.47 / $93.08	Professional	TC	$48.72	$74.47	$93.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.89 / $75.05 / $359.16	Professional		$42.89	$75.05	$359.16
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $45.24 / $197.46	Professional	26	$26.92	$45.24	$197.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.52 / $35.52 / $214.27	Professional	TC	$13.52	$35.52	$214.27
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $77.08 / $77.08 / $77.08	Facility	26	$77.08	$77.08	$77.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.16 / $128.34 / $142.46	Professional		$70.16	$128.34	$142.46
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $79.87 / $124.85	Professional		$43.93	$79.87	$124.85
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.14 / $47.27 / $63.40	Professional	26	$30.14	$47.27	$63.40
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.73 / $40.61 / $61.46	Professional	TC	$13.73	$40.61	$61.46
United Facility/Professional Professional Modifier Low / Median / High Price $50.60 / $75.90 / $106.23	Professional		$50.60	$75.90	$106.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.34 / $44.01 / $71.37	Professional	26	$29.34	$44.01	$71.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $37.15 / $60.99	Professional	TC	$14.84	$37.15	$60.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.40 / $134.60 / $134.60	Professional		$114.40	$134.60	$134.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $58.10 / $68.40 / $68.40	Professional	26	$58.10	$68.40	$68.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $56.30 / $66.30 / $66.30	Professional	TC	$56.30	$66.30	$66.30