Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $72.44 / $104.71	Professional		$47.86	$72.44	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $47.86 / $107.15	Professional	26	$25.12	$47.86	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $61.66	Professional	TC	$26.92	$38.02	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $177.83	Professional		$85.11	$117.49	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $46.77 / $69.18	Professional	26	$33.11	$46.77	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $64.57 / $107.15	Professional	TC	$51.29	$64.57	$107.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $107.15 / $165.96	Facility		$70.79	$107.15	$165.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $645.65	Professional		$40.74	$63.10	$645.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $47.86 / $512.86	Professional	26	$17.38	$47.86	$512.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $70.79 / $309.03	Professional	TC	$23.44	$70.79	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $51.29 / $51.29	Professional	26	$46.77	$51.29	$51.29
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $64.57 / $72.44	Professional	TC	$64.57	$64.57	$72.44
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $154.88	Professional		$97.72	$125.89	$154.88
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $85.11	Professional	26	$38.90	$51.29	$85.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $69.18 / $79.43	Professional	TC	$54.95	$69.18	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $54.95 / $138.04	Professional		$40.74	$54.95	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.91 / $57.54	Professional	26	$15.85	$22.91	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $31.62 / $79.43	Professional	TC	$23.44	$31.62	$79.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $158.49	Professional		$114.82	$147.91	$158.49
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $58.88 / $63.10	Professional	26	$45.71	$58.88	$63.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $89.13 / $95.50	Professional	TC	$69.18	$89.13	$95.50