Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.40 / $51.40 / $51.40	Facility	26	$51.40	$51.40	$51.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.79 / $105.29 / $175.80	Professional		$84.79	$105.29	$175.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.42 / $44.39 / $79.50	Professional	26	$43.42	$44.39	$79.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.40 / $61.86 / $114.95	Professional	TC	$40.40	$61.86	$114.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.43 / $221.85 / $277.31	Professional		$181.43	$221.85	$277.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.52 / $115.58 / $144.47	Professional	26	$94.52	$115.58	$144.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.91 / $106.27 / $132.84	Professional	TC	$86.91	$106.27	$132.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.51 / $171.63 / $212.68	Professional		$91.51	$171.63	$212.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.32 / $92.14 / $138.69	Professional	26	$54.32	$92.14	$138.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $52.99 / $81.70 / $125.94	Professional	TC	$52.99	$81.70	$125.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $180.45 / $212.68 / $323.79	Professional		$180.45	$212.68	$323.79
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $110.70 / $157.27 / $185.01	Professional		$110.70	$157.27	$185.01
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.78 / $80.81 / $97.68	Professional	26	$58.78	$80.81	$97.68
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $51.91 / $74.23 / $87.33	Professional	TC	$51.91	$74.23	$87.33
United Facility/Professional Professional Modifier Low / Median / High Price $112.39 / $143.47 / $187.32	Professional		$112.39	$143.47	$187.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.32 / $61.43 / $98.76	Professional	26	$54.32	$61.43	$98.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.99 / $64.19 / $92.99	Professional	TC	$52.99	$64.19	$92.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $176.20 / $207.40 / $207.40	Professional		$176.20	$207.40	$207.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $93.10 / $109.50 / $109.50	Professional	26	$93.10	$109.50	$109.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $83.20 / $97.90 / $97.90	Professional	TC	$83.20	$97.90	$97.90