Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $79.20 / $83.70	Professional		$45.50	$79.20	$83.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.96 / $21.57 / $82.77	Professional	26	$16.96	$21.57	$82.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.54 / $28.54 / $130.83	Professional	TC	$28.54	$28.54	$130.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.97 / $105.00 / $173.81	Professional		$87.97	$105.00	$173.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $37.85 / $84.00	Professional	26	$26.85	$37.85	$84.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $63.35 / $120.77	Professional	TC	$21.00	$63.35	$120.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.18 / $91.03 / $215.28	Facility		$77.18	$91.03	$215.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $104.67 / $407.64	Professional		$37.61	$104.67	$407.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.94 / $56.11 / $244.00	Professional	26	$13.94	$56.11	$244.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.68 / $61.84 / $268.50	Professional	TC	$23.68	$61.84	$268.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $81.26 / $124.00 / $188.10	Facility		$81.26	$124.00	$188.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $56.79 / $56.79 / $56.79	Facility	26	$56.79	$56.79	$56.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $113.00 / $143.35	Professional		$92.00	$113.00	$143.35
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $94.61 / $118.26 / $137.51	Professional		$94.61	$118.26	$137.51
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $28.43 / $38.29 / $44.03	Professional	26	$28.43	$38.29	$44.03
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $61.25 / $79.73 / $99.21	Professional	TC	$61.25	$79.73	$99.21
United Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $41.14 / $126.18	Professional		$37.61	$41.14	$126.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $13.94 / $42.25	Professional	26	$12.98	$13.94	$42.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.68 / $28.16 / $79.23	Professional	TC	$23.68	$28.16	$79.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $119.10 / $153.30 / $164.80	Professional		$119.10	$153.30	$164.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $36.90 / $47.50 / $51.00	Professional	26	$36.90	$47.50	$51.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $82.30 / $105.90 / $113.80	Professional	TC	$82.30	$105.90	$113.80