Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $72.44 / $128.82	Professional		$51.29	$72.44	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.91 / $38.90	Professional	26	$19.05	$22.91	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $48.98 / $89.13	Professional	TC	$32.36	$48.98	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $131.83 / $218.78	Professional		$104.71	$131.83	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.66 / $63.10	Professional	26	$30.90	$42.66	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $93.33 / $154.88	Professional	TC	$67.61	$93.33	$154.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $64.57 / $467.74	Professional		$41.69	$64.57	$467.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $25.12 / $186.21	Professional	26	$15.85	$25.12	$186.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.90 / $309.03	Professional	TC	$25.70	$38.90	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $147.91	Professional		$114.82	$114.82	$147.91
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $46.77 / $46.77	Professional	26	$42.66	$46.77	$46.77
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $104.71	Professional	TC	$67.61	$67.61	$104.71
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $138.04 / $162.18	Professional		$77.62	$138.04	$162.18
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $47.86	Professional	26	$30.90	$41.69	$47.86
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $97.72 / $114.82	Professional	TC	$44.67	$97.72	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $154.88	Professional		$41.69	$52.48	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $20.89 / $52.48	Professional	26	$14.45	$20.89	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $109.65	Professional	TC	$25.70	$33.88	$109.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $199.53	Professional		$144.54	$181.97	$199.53
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $53.70 / $57.54	Professional	26	$41.69	$53.70	$57.54
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $128.82 / $141.25	Professional	TC	$100.00	$128.82	$141.25