Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.87 / $28.87 / $28.87	Facility	26	$28.87	$28.87	$28.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.06 / $106.50 / $178.06	Professional		$94.06	$106.50	$178.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.88 / $28.87 / $113.40	Professional	26	$24.88	$28.87	$113.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $80.84 / $212.71	Professional	TC	$69.18	$80.84	$212.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.40 / $248.22 / $310.27	Professional		$162.40	$248.22	$310.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.63 / $65.16 / $81.45	Professional	26	$42.63	$65.16	$81.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.77 / $183.07 / $228.83	Professional	TC	$119.77	$183.07	$228.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $201.28 / $674.54	Professional		$109.71	$201.28	$674.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.60 / $54.82 / $180.38	Professional	26	$32.60	$54.82	$180.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $86.22 / $146.46 / $494.15	Professional	TC	$86.22	$146.46	$494.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $89.01 / $89.01 / $89.01	Facility	26	$89.01	$89.01	$89.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $225.59 / $239.60 / $285.95	Professional		$225.59	$239.60	$285.95
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $131.47 / $179.87 / $205.07	Professional		$131.47	$179.87	$205.07
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.63 / $46.74 / $54.99	Professional	26	$30.63	$46.74	$54.99
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $78.93 / $127.58 / $150.08	Professional	TC	$78.93	$127.58	$150.08
United Facility/Professional Professional Modifier Low / Median / High Price $118.82 / $195.84 / $216.04	Professional		$118.82	$195.84	$216.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.60 / $44.46 / $63.84	Professional	26	$32.60	$44.46	$63.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.22 / $101.96 / $156.76	Professional	TC	$86.22	$101.96	$156.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $187.90 / $221.10 / $221.10	Professional		$187.90	$221.10	$221.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $50.40 / $59.30 / $59.30	Professional	26	$50.40	$59.30	$59.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $137.50 / $161.80 / $161.80	Professional	TC	$137.50	$161.80	$161.80