Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.53 / $48.53 / $72.53	Professional		$48.53	$48.53	$72.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.96 / $20.96 / $52.84	Professional	26	$20.96	$20.96	$52.84
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 $84.67 / $116.79 / $167.28	Professional		$84.67	$116.79	$167.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $46.58 / $65.28	Professional	26	$33.04	$46.58	$65.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.63 / $65.12 / $102.00	Professional	TC	$51.63	$65.12	$102.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.43 / $107.84 / $166.56	Facility		$70.43	$107.84	$166.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $120.88 / $641.00	Professional		$40.86	$120.88	$641.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.19 / $64.31 / $513.00	Professional	26	$17.19	$64.31	$513.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.68 / $79.23 / $312.17	Professional	TC	$23.68	$79.23	$312.17
Midlands Facility/Professional Facility Modifier Low / Median / High Price $78.84 / $147.88 / $274.43	Facility		$78.84	$147.88	$274.43
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $150.38 / $150.38 / $150.38	Facility	26	$150.38	$150.38	$150.38
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $124.05 / $124.05 / $124.05	Facility	TC	$124.05	$124.05	$124.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.95 / $118.19 / $184.00	Professional		$102.95	$118.19	$184.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $82.69 / $115.18 / $153.68	Professional		$82.69	$115.18	$153.68
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $46.42 / $85.13	Professional	26	$34.88	$46.42	$85.13
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.81 / $67.64 / $79.56	Professional	TC	$47.81	$67.64	$79.56
United Facility/Professional Professional Modifier Low / Median / High Price $40.75 / $40.86 / $123.25	Professional		$40.75	$40.86	$123.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $17.19 / $57.70	Professional	26	$15.98	$17.19	$57.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.68 / $24.77 / $71.31	Professional	TC	$23.68	$24.77	$71.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $115.20 / $148.19 / $159.40	Professional		$115.20	$148.19	$159.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $45.40 / $58.40 / $62.80	Professional	26	$45.40	$58.40	$62.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $69.80 / $89.80 / $96.60	Professional	TC	$69.80	$89.80	$96.60