Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.75 / $71.75 / $71.75	Professional		$71.75	$71.75	$71.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.27 / $16.27 / $16.27	Professional	26	$16.27	$16.27	$16.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.49 / $55.49 / $55.49	Professional	TC	$55.49	$55.49	$55.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $149.63 / $228.48	Professional		$28.00	$149.63	$228.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.40 / $33.63 / $50.09	Professional	26	$8.40	$33.63	$50.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.60 / $115.87 / $178.39	Professional	TC	$19.60	$115.87	$178.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.84 / $157.76 / $626.79	Professional		$58.84	$157.76	$626.79
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.72 / $41.60 / $171.71	Professional	26	$13.72	$41.60	$171.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.61 / $100.38 / $496.32	Professional	TC	$44.61	$100.38	$496.32
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $58.76 / $58.76 / $58.76	Facility	26	$58.76	$58.76	$58.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $154.50 / $194.27	Professional		$103.00	$154.50	$194.27
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $91.50 / $133.72 / $166.25	Professional		$91.50	$133.72	$166.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.88 / $34.85 / $38.03	Professional	26	$27.88	$34.85	$38.03
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $67.95 / $97.31 / $128.72	Professional	TC	$67.95	$97.31	$128.72
United Facility/Professional Professional Modifier Low / Median / High Price $53.12 / $58.84 / $241.97	Professional		$53.12	$58.84	$241.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $13.72 / $46.22	Professional	26	$11.78	$13.72	$46.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.34 / $45.12 / $111.54	Professional	TC	$41.34	$45.12	$111.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $145.80 / $187.60 / $201.70	Professional		$145.80	$187.60	$201.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $32.90 / $42.30 / $45.50	Professional	26	$32.90	$42.30	$45.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $112.90 / $145.30 / $156.19	Professional	TC	$112.90	$145.30	$156.19