Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.93 / $61.93 / $61.93	Facility	26	$61.93	$61.93	$61.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.08 / $151.90 / $230.28	Professional		$113.08	$151.90	$230.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.92 / $61.93 / $792.00	Professional	26	$56.92	$61.93	$792.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.49 / $94.98 / $150.81	Professional	TC	$59.49	$94.98	$150.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.97 / $297.08 / $371.37	Professional		$242.97	$297.08	$371.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $140.40 / $175.50	Professional	26	$114.82	$140.40	$175.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.13 / $156.69 / $195.86	Professional	TC	$128.13	$156.69	$195.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.92 / $232.04 / $290.31	Professional		$121.92	$232.04	$290.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.48 / $114.07 / $167.30	Professional	26	$71.48	$114.07	$167.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $121.05 / $205.55	Professional	TC	$80.70	$121.05	$205.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $254.53 / $290.31 / $351.36	Professional		$254.53	$290.31	$351.36
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $161.88 / $215.61 / $247.17	Professional		$161.88	$215.61	$247.17
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $76.80 / $103.27 / $117.74	Professional	26	$76.80	$103.27	$117.74
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $88.64 / $116.00 / $145.71	Professional	TC	$88.64	$116.00	$145.71
United Facility/Professional Professional Modifier Low / Median / High Price $150.59 / $238.48 / $285.26	Professional		$150.59	$238.48	$285.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.53 / $73.98 / $119.14	Professional	26	$65.53	$73.98	$119.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.68 / $97.79 / $147.66	Professional	TC	$78.68	$97.79	$147.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $234.20 / $275.50 / $275.50	Professional		$234.20	$275.50	$275.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $132.00 / $132.00	Professional	26	$112.20	$132.00	$132.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $122.00 / $143.60 / $143.60	Professional	TC	$122.00	$143.60	$143.60