Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $309.03	Professional		$128.82	$151.36	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $162.18 / $891.25	Professional	26	$57.54	$162.18	$891.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $95.50 / $158.49	Professional	TC	$67.61	$95.50	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $302.00 / $380.19	Professional		$275.42	$302.00	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $144.54 / $177.83	Professional	26	$131.83	$144.54	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $162.18 / $199.53	Professional	TC	$147.91	$162.18	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $288.40	Professional		$123.03	$177.83	$288.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $112.20 / $199.53	Professional	26	$61.66	$112.20	$199.53
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $97.72 / $151.36	Professional	TC	$57.54	$97.72	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	TC	$147.91	$147.91	$147.91
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $251.19	Professional		$169.82	$223.87	$251.19
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $102.33 / $117.49	Professional	26	$77.62	$102.33	$117.49
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $123.03 / $144.54	Professional	TC	$89.13	$123.03	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $194.98 / $288.40	Professional		$151.36	$194.98	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $85.11 / $134.90	Professional	26	$66.07	$85.11	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $117.49 / $165.96	Professional	TC	$79.43	$117.49	$165.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $275.42 / $275.42	Professional		$234.42	$275.42	$275.42
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $131.83 / $131.83	Professional	26	$112.20	$131.83	$131.83
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $144.54 / $144.54	Professional	TC	$123.03	$144.54	$144.54