Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.83 / $46.83 / $46.83	Facility	26	$46.83	$46.83	$46.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.13 / $60.27 / $106.48	Professional		$58.13	$60.27	$106.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.32 / $44.36 / $149.52	Professional	26	$40.32	$44.36	$149.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $19.94 / $33.35	Professional	TC	$17.38	$19.94	$33.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.70 / $151.26 / $189.08	Professional		$123.70	$151.26	$189.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.91 / $106.27 / $132.84	Professional	26	$86.91	$106.27	$132.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.79 / $44.99 / $56.24	Professional	TC	$36.79	$44.99	$56.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.72 / $117.88 / $147.99	Professional		$62.72	$117.88	$147.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.58 / $83.86 / $126.56	Professional	26	$49.58	$83.86	$126.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.09 / $34.02 / $54.46	Professional	TC	$21.09	$34.02	$54.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.00 / $146.30 / $172.13	Professional		$117.00	$146.30	$172.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $76.80 / $105.59 / $127.44	Professional		$76.80	$105.59	$127.44
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.06 / $74.33 / $89.92	Professional	26	$54.06	$74.33	$89.92
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.54 / $31.26 / $37.52	Professional	TC	$21.54	$31.26	$37.52
United Facility/Professional Professional Modifier Low / Median / High Price $77.08 / $121.16 / $143.21	Professional		$77.08	$121.16	$143.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.09 / $83.86 / $127.81	Professional	26	$54.09	$83.86	$127.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.09 / $23.17 / $38.32	Professional	TC	$21.09	$23.17	$38.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $121.40 / $142.80 / $142.80	Professional		$121.40	$142.80	$142.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $85.70 / $100.80 / $100.80	Professional	26	$85.70	$100.80	$100.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.70 / $42.00 / $42.00	Professional	TC	$35.70	$42.00	$42.00