Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $40.65	Professional		$40.65	$40.65	$40.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $92.56 / $94.34	Professional	26	$26.92	$92.56	$94.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.73 / $13.73 / $13.73	Professional	TC	$13.73	$13.73	$13.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $88.20 / $138.72	Professional		$70.20	$88.20	$138.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.54 / $59.98 / $84.05	Professional	26	$42.54	$59.98	$84.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $32.65 / $54.67	Professional	TC	$18.20	$32.65	$54.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $99.13 / $473.28	Professional		$33.94	$99.13	$473.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $75.22 / $346.00	Professional	26	$22.39	$75.22	$346.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $11.55 / $30.30 / $330.22	Professional	TC	$11.55	$30.30	$330.22
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $89.86 / $89.86 / $89.86	Facility	26	$89.86	$89.86	$89.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $98.41 / $110.19	Professional		$79.00	$98.41	$110.19
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $66.28 / $92.25 / $109.33	Professional		$66.28	$92.25	$109.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.11 / $58.44 / $66.63	Professional	26	$36.11	$58.44	$66.63
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $36.29 / $42.70	Professional	TC	$24.12	$36.29	$42.70
United Facility/Professional Professional Modifier Low / Median / High Price $33.35 / $33.94 / $114.98	Professional		$33.35	$33.94	$114.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.37 / $22.39 / $75.22	Professional	26	$20.37	$22.39	$75.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.55 / $12.98 / $39.76	Professional	TC	$11.55	$12.98	$39.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $123.40 / $132.69	Professional		$95.90	$123.40	$132.69
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $58.40 / $75.20 / $80.90	Professional	26	$58.40	$75.20	$80.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.40 / $48.20 / $51.80	Professional	TC	$37.40	$48.20	$51.80