Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.79 / $611.60 / $856.18	Facility		$40.79	$611.60	$856.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.77 / $13.77 / $13.77	Facility	26	$13.77	$13.77	$13.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.09 / $34.14 / $63.67	Professional		$34.09	$34.14	$63.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.82 / $20.47 / $63.90	Professional	26	$12.82	$20.47	$63.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.28 / $22.23 / $38.27	Professional	TC	$20.28	$22.23	$38.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $89.21 / $111.51	Professional		$58.36	$89.21	$111.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.79 / $30.25 / $37.82	Professional	26	$19.79	$30.25	$37.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.57 / $58.95 / $73.69	Professional	TC	$38.57	$58.95	$73.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.15 / $57.61 / $84.48	Facility		$46.15	$57.61	$84.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.17 / $66.09 / $287.00	Professional		$37.17	$66.09	$287.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $26.53 / $204.67	Professional	26	$15.71	$26.53	$204.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.67 / $37.04 / $230.00	Professional	TC	$20.67	$37.04	$230.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $81.84 / $130.19	Facility		$64.00	$81.84	$130.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $47.67 / $47.67 / $47.67	Facility	26	$47.67	$47.67	$47.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $37.01 / $76.33 / $98.48	Professional		$37.01	$76.33	$98.48
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $55.46 / $74.39	Professional		$39.50	$55.46	$74.39
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.64 / $22.70 / $25.88	Professional	26	$17.64	$22.70	$25.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $36.17 / $48.52	Professional	TC	$21.02	$36.17	$48.52
United Facility/Professional Professional Modifier Low / Median / High Price $37.40 / $45.94 / $67.93	Professional		$37.40	$45.94	$67.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $18.57 / $28.56	Professional	26	$15.71	$18.57	$28.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.67 / $29.56 / $41.40	Professional	TC	$20.67	$29.56	$41.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $80.20 / $80.20	Professional		$68.20	$80.20	$80.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $23.70 / $27.90 / $27.90	Professional	26	$23.70	$27.90	$27.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.50 / $52.30 / $52.30	Professional	TC	$44.50	$52.30	$52.30