Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.77 / $26.77 / $26.77	Facility	26	$26.77	$26.77	$26.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.64 / $103.01 / $149.43	Professional		$89.64	$103.01	$149.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.07 / $26.77 / $38.99	Professional	26	$23.07	$26.77	$38.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.56 / $78.43 / $113.68	Professional	TC	$66.56	$78.43	$113.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.31 / $232.71 / $290.89	Professional		$190.31	$232.71	$290.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.85 / $59.73 / $74.66	Professional	26	$48.85	$59.73	$74.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.78 / $172.98 / $216.23	Professional	TC	$137.78	$172.98	$216.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.90 / $174.84 / $642.13	Professional		$104.90	$174.84	$642.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.38 / $51.49 / $167.46	Professional	26	$32.38	$51.49	$167.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $72.52 / $120.88 / $474.67	Professional	TC	$72.52	$120.88	$474.67
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $85.89 / $85.89 / $85.89	Facility	26	$85.89	$85.89	$85.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $149.00 / $205.33 / $249.80	Professional		$149.00	$205.33	$249.80
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $105.95 / $159.28 / $192.13	Professional		$105.95	$159.28	$192.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $44.26 / $50.46	Professional	26	$33.04	$44.26	$50.46
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $74.89 / $117.42 / $141.66	Professional	TC	$74.89	$117.42	$141.66
United Facility/Professional Professional Modifier Low / Median / High Price $106.57 / $142.10 / $183.58	Professional		$106.57	$142.10	$183.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.16 / $51.49 / $53.96	Professional	26	$31.16	$51.49	$53.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.63 / $98.83 / $125.76	Professional	TC	$78.63	$98.83	$125.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $183.00 / $215.30 / $215.30	Professional		$183.00	$215.30	$215.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $48.10 / $56.60 / $56.60	Professional	26	$48.10	$56.60	$56.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $135.00 / $158.80 / $158.80	Professional	TC	$135.00	$158.80	$158.80