Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.44 / $509.08 / $514.79	Professional		$112.44	$509.08	$514.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.18 / $242.97 / $560.70	Professional	26	$53.18	$242.97	$560.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.26 / $59.26 / $59.26	Professional	TC	$59.26	$59.26	$59.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.00 / $266.08 / $423.50	Professional		$175.00	$266.08	$423.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.84 / $117.61 / $165.65	Professional	26	$83.84	$117.61	$165.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.00 / $135.69 / $257.86	Professional	TC	$35.00	$135.69	$257.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.61 / $188.05 / $391.63	Facility		$165.61	$188.05	$391.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.73 / $278.41 / $1,961.76	Professional		$93.73	$278.41	$1,961.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.98 / $175.85 / $434.05	Professional	26	$43.98	$175.85	$434.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.75 / $145.85 / $557.54	Professional	TC	$49.75	$145.85	$557.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $199.39 / $240.00 / $392.99	Facility		$199.39	$240.00	$392.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $181.03 / $181.03 / $181.03	Facility	26	$181.03	$181.03	$181.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $195.00 / $266.08 / $316.23	Professional		$195.00	$266.08	$316.23
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $167.28 / $246.00 / $332.51	Professional		$167.28	$246.00	$332.51
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $114.61 / $130.66	Professional	26	$83.18	$114.61	$130.66
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $94.21 / $142.51 / $201.83	Professional	TC	$94.21	$142.51	$201.83
United Facility/Professional Professional Modifier Low / Median / High Price $93.73 / $100.26 / $309.33	Professional		$93.73	$100.26	$309.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.34 / $43.98 / $147.28	Professional	26	$40.34	$43.98	$147.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.75 / $59.92 / $162.06	Professional	TC	$49.75	$59.92	$162.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $291.60 / $375.20 / $403.50	Professional		$291.60	$375.20	$403.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.60 / $147.50 / $158.60	Professional	26	$114.60	$147.50	$158.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $177.00 / $227.80 / $244.90	Professional	TC	$177.00	$227.80	$244.90