Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.03 / $315.95 / $337.50	Professional		$80.03	$315.95	$337.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.17 / $85.50 / $384.48	Professional	26	$20.17	$85.50	$384.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.86 / $231.40 / $475.26	Professional	TC	$59.86	$231.40	$475.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.80 / $185.22 / $298.77	Professional		$30.80	$185.22	$298.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $44.84 / $67.66	Professional	26	$9.80	$44.84	$67.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $143.27 / $231.11	Professional	TC	$21.00	$143.27	$231.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.88 / $126.94 / $248.47	Facility		$99.88	$126.94	$248.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.04 / $201.43 / $715.47	Professional		$64.04	$201.43	$715.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.54 / $53.41 / $162.69	Professional	26	$16.54	$53.41	$162.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $47.50 / $128.18 / $552.78	Professional	TC	$47.50	$128.18	$552.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $129.29 / $221.73 / $262.55	Facility		$129.29	$221.73	$262.55
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $69.80 / $69.80 / $69.80	Facility	26	$69.80	$69.80	$69.80
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $180.75 / $180.75 / $180.75	Facility	TC	$180.75	$180.75	$180.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $143.00 / $187.27 / $221.73	Professional		$143.00	$187.27	$221.73
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $117.13 / $163.97 / $216.71	Professional		$117.13	$163.97	$216.71
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.99 / $43.69 / $49.81	Professional	26	$31.99	$43.69	$49.81
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.43 / $124.43 / $166.90	Professional	TC	$87.43	$124.43	$166.90
United Facility/Professional Professional Modifier Low / Median / High Price $64.04 / $67.51 / $248.16	Professional		$64.04	$67.51	$248.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.38 / $16.54 / $50.63	Professional	26	$15.38	$16.54	$50.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.50 / $52.13 / $128.18	Professional	TC	$47.50	$52.13	$128.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $190.10 / $244.60 / $263.00	Professional		$190.10	$244.60	$263.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $43.70 / $56.20 / $60.40	Professional	26	$43.70	$56.20	$60.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $146.40 / $188.40 / $202.50	Professional	TC	$146.40	$188.40	$202.50