Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.26 / $51.26 / $51.26	Professional		$51.26	$51.26	$51.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $19.32 / $19.32	Professional	26	$19.32	$19.32	$19.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.94 / $31.94 / $31.94	Professional	TC	$31.94	$31.94	$31.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.60 / $123.05 / $206.45	Professional		$61.60	$123.05	$206.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.40 / $38.72 / $61.20	Professional	26	$29.40	$38.72	$61.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.20 / $75.34 / $145.25	Professional	TC	$32.20	$75.34	$145.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.25 / $89.66 / $453.03	Professional		$43.25	$89.66	$453.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.11 / $48.71 / $158.49	Professional	26	$16.11	$48.71	$158.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.14 / $39.77 / $300.38	Professional	TC	$27.14	$39.77	$300.38
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $65.73 / $65.73 / $65.73	Facility	26	$65.73	$65.73	$65.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $123.05 / $149.38	Professional		$84.00	$123.05	$149.38
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $66.28 / $109.08 / $161.72	Professional		$66.28	$109.08	$161.72
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.71 / $41.24 / $48.52	Professional	26	$29.71	$41.24	$48.52
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.56 / $65.56 / $113.21	Professional	TC	$36.56	$65.56	$113.21
United Facility/Professional Professional Modifier Low / Median / High Price $43.25 / $47.74 / $146.28	Professional		$43.25	$47.74	$146.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.78 / $16.11 / $54.12	Professional	26	$14.78	$16.11	$54.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.14 / $32.96 / $82.94	Professional	TC	$27.14	$32.96	$82.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.80 / $182.50 / $196.30	Professional		$141.80	$182.50	$196.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $54.80 / $58.90	Professional	26	$42.60	$54.80	$58.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $99.30 / $127.80 / $137.40	Professional	TC	$99.30	$127.80	$137.40