Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $363.08	Professional		$128.82	$151.36	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $57.54 / $128.82	Professional	TC	$47.86	$57.54	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $346.74 / $436.52	Professional		$316.23	$346.74	$436.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $128.82 / $162.18	Professional	TC	$109.65	$128.82	$162.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $338.84	Professional		$138.04	$190.55	$338.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $67.61 / $102.33	Professional	TC	$44.67	$67.61	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	26	$229.09	$229.09	$229.09
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $109.65 / $109.65	Professional	TC	$109.65	$109.65	$109.65
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $239.88 / $281.84	Professional		$199.53	$239.88	$281.84
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $158.49 / $177.83	Professional	26	$123.03	$158.49	$177.83
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $89.13 / $104.71	Professional	TC	$69.18	$89.13	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $229.09 / $323.59	Professional		$173.78	$229.09	$323.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $87.10 / $123.03	Professional	TC	$58.88	$87.10	$123.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $295.12 / $295.12	Professional		$251.19	$295.12	$295.12
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $107.15 / $107.15	Professional	TC	$91.20	$107.15	$107.15