Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $660.69 / $977.24	Facility		$234.42	$660.69	$977.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $26.92 / $26.92	Facility	26	$26.92	$26.92	$26.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $123.03 / $316.23	Professional		$58.88	$123.03	$316.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $42.66 / $87.10	Professional	26	$25.12	$42.66	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $95.50 / $223.87	Professional	TC	$69.18	$95.50	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $338.84	Professional		$218.78	$275.42	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $77.62	Professional	26	$48.98	$61.66	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $213.80 / $263.03	Professional	TC	$169.82	$213.80	$263.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $177.83 / $676.08	Facility		$141.25	$177.83	$676.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $758.58	Professional		$93.33	$131.83	$758.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $36.31 / $169.82	Professional	26	$26.30	$36.31	$169.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $97.72 / $588.84	Professional	TC	$69.18	$97.72	$588.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $239.88	Professional		$223.87	$223.87	$239.88
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $57.54 / $64.57	Professional	26	$56.23	$57.54	$64.57
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $186.21	Professional	TC	$162.18	$162.18	$186.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	26	$57.54	$57.54	$57.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $165.96 / $165.96	Professional	TC	$165.96	$165.96	$165.96
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $186.21 / $218.78	Professional		$85.11	$186.21	$218.78
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $51.29	Professional	26	$33.11	$44.67	$51.29
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $144.54 / $169.82	Professional	TC	$52.48	$144.54	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $169.82 / $257.04	Professional		$102.33	$169.82	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $44.67 / $61.66	Professional	26	$30.90	$44.67	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $112.20 / $194.98	Professional	TC	$72.44	$112.20	$194.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $229.09 / $229.09	Professional		$194.98	$229.09	$229.09
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $52.48 / $52.48	Professional	26	$44.67	$52.48	$52.48
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $173.78 / $173.78	Professional	TC	$147.91	$173.78	$173.78