Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.30 / $221.40 / $235.80	Professional		$57.30	$221.40	$235.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $39.15 / $96.12	Professional	26	$9.09	$39.15	$96.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.20 / $69.91 / $595.41	Professional	TC	$48.20	$69.91	$595.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.80 / $135.63 / $218.81	Professional		$30.80	$135.63	$218.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $20.05 / $29.88	Professional	26	$9.80	$20.05	$29.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $117.12 / $188.93	Professional	TC	$21.00	$117.12	$188.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.22 / $93.39 / $171.26	Facility		$71.22	$93.39	$171.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $140.54 / $514.55	Professional		$46.07	$140.54	$514.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $20.68 / $87.52	Professional	26	$7.44	$20.68	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.63 / $72.87 / $439.92	Professional	TC	$38.63	$72.87	$439.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.61 / $159.41 / $192.05	Facility		$94.61	$159.41	$192.05
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $31.15 / $31.15 / $31.15	Facility	26	$31.15	$31.15	$31.15
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $144.09 / $144.09 / $144.09	Facility	TC	$144.09	$144.09	$144.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $123.92 / $159.41	Professional		$102.00	$123.92	$159.41
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $82.68 / $120.14 / $159.13	Professional		$82.68	$120.14	$159.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.17 / $19.86 / $22.64	Professional	26	$14.17	$19.86	$22.64
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $70.81 / $101.77 / $136.50	Professional	TC	$70.81	$101.77	$136.50
United Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $49.73 / $232.64	Professional		$46.07	$49.73	$232.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $7.44 / $24.68	Professional	26	$6.99	$7.44	$24.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.63 / $42.74 / $115.86	Professional	TC	$38.63	$42.74	$115.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $139.60 / $179.60 / $193.10	Professional		$139.60	$179.60	$193.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $25.60 / $27.50	Professional	26	$19.89	$25.60	$27.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $154.00 / $165.60	Professional	TC	$119.70	$154.00	$165.60