Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $56.23 / $56.23	Facility	26	$56.23	$56.23	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $186.21 / $426.58	Professional		$181.97	$186.21	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $151.36	Professional	26	$53.70	$61.66	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $128.82 / $288.40	Professional	TC	$109.65	$128.82	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $416.87 / $524.81	Professional		$338.84	$416.87	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $128.82 / $162.18	Professional	26	$104.71	$128.82	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $288.40 / $363.08	Professional	TC	$234.42	$288.40	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $398.11	Professional		$169.82	$239.88	$398.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $141.25	Professional	26	$51.29	$77.62	$141.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $158.49 / $346.74	Professional	TC	$104.71	$158.49	$346.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	26	$138.04	$138.04	$138.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $263.03 / $263.03	Professional	TC	$263.03	$263.03	$263.03
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $295.12 / $338.84	Professional		$229.09	$295.12	$338.84
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $97.72 / $107.15	Professional	26	$72.44	$97.72	$107.15
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $199.53 / $234.42	Professional	TC	$151.36	$199.53	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $398.11	Professional		$208.93	$295.12	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $91.20 / $125.89	Professional	26	$64.57	$91.20	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $275.42	Professional	TC	$144.54	$218.78	$275.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $354.81 / $354.81	Professional		$302.00	$354.81	$354.81
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $112.20	Professional	26	$95.50	$112.20	$112.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $239.88 / $239.88	Professional	TC	$204.17	$239.88	$239.88