Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $263.03 / $512.86	Professional		$131.83	$263.03	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $134.90 / $562.34	Professional	26	$64.57	$134.90	$562.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $89.13 / $158.49	Professional	TC	$58.88	$89.13	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $446.68	Professional		$213.80	$269.15	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $173.78	Professional	26	$83.18	$117.49	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $162.18 / $269.15	Professional	TC	$131.83	$162.18	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $186.21 / $389.05	Facility		$165.96	$186.21	$389.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $269.15 / $1,949.84	Professional		$93.33	$269.15	$1,949.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $131.83 / $436.52	Professional	26	$43.65	$131.83	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $75.86 / $562.34	Professional	TC	$50.12	$75.86	$562.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $302.00	Professional		$269.15	$269.15	$302.00
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $131.83 / $131.83	Professional	26	$117.49	$131.83	$131.83
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $134.90 / $181.97	Professional	TC	$134.90	$134.90	$181.97
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $281.84 / $331.13	Professional		$165.96	$281.84	$331.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $117.49 / $131.83	Professional	26	$87.10	$117.49	$131.83
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $169.82 / $199.53	Professional	TC	$97.72	$169.82	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $309.03	Professional		$93.33	$123.03	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $58.88 / $147.91	Professional	26	$40.74	$58.88	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $64.57 / $190.55	Professional	TC	$50.12	$64.57	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $371.54 / $407.38	Professional		$288.40	$371.54	$407.38
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $147.91 / $158.49	Professional	26	$114.82	$147.91	$158.49
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $229.09 / $245.47	Professional	TC	$177.83	$229.09	$245.47