Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $48.28 / $48.28	Professional		$48.28	$48.28	$48.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.72 / $20.72 / $20.72	Professional	26	$20.72	$20.72	$20.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.57 / $27.57 / $27.57	Professional	TC	$27.57	$27.57	$27.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $121.61 / $198.29	Professional		$70.00	$121.61	$198.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.45 / $47.16 / $66.09	Professional	26	$33.45	$47.16	$66.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $69.36 / $132.19	Professional	TC	$22.40	$69.36	$132.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.52 / $121.61 / $424.65	Professional		$41.52	$121.61	$424.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $53.87 / $214.00	Professional	26	$17.39	$53.87	$214.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $39.14 / $272.93	Professional	TC	$24.12	$39.14	$272.93
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $73.45 / $73.45 / $73.45	Facility	26	$73.45	$73.45	$73.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $121.61 / $147.62	Professional		$79.00	$121.61	$147.62
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $121.84 / $155.26	Professional		$81.81	$121.84	$155.26
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.82 / $44.58 / $52.40	Professional	26	$33.82	$44.58	$52.40
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.99 / $73.69 / $102.86	Professional	TC	$47.99	$73.69	$102.86
United Facility/Professional Professional Modifier Low / Median / High Price $41.52 / $45.34 / $149.86	Professional		$41.52	$45.34	$149.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $17.39 / $59.86	Professional	26	$15.98	$17.39	$59.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $29.36 / $81.00	Professional	TC	$24.12	$29.36	$81.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $136.19 / $175.20 / $188.40	Professional		$136.19	$175.20	$188.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $46.00 / $59.10 / $63.60	Professional	26	$46.00	$59.10	$63.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $90.20 / $116.10 / $124.80	Professional	TC	$90.20	$116.10	$124.80