Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.27 / $91.27 / $91.27	Facility	26	$91.27	$91.27	$91.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.27 / $137.32 / $265.00	Professional	26	$91.27	$137.32	$265.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.57 / $202.46 / $253.07	Professional	26	$165.57	$202.46	$253.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $103.26 / $167.57 / $197.13	Professional	26	$103.26	$167.57	$197.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $99.52 / $150.36 / $171.43	Professional	26	$99.52	$150.36	$171.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.26 / $111.71 / $187.74	Professional	26	$103.26	$111.71	$187.74
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $170.10 / $200.10 / $200.10	Professional	26	$170.10	$200.10	$200.10