Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $76.00 / $76.00	Professional		$76.00	$76.00	$76.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.74 / $115.82 / $223.20	Professional	26	$46.74	$115.82	$223.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.27 / $29.27 / $29.27	Professional	TC	$29.27	$29.27	$29.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.19 / $170.88 / $267.14	Professional		$130.19	$170.88	$267.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.44 / $106.20 / $158.18	Professional	26	$78.44	$106.20	$158.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.00 / $67.55 / $108.97	Professional	TC	$42.00	$67.55	$108.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $113.50 / $115.81 / $269.49	Facility		$113.50	$115.81	$269.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $170.88 / $643.49	Professional		$59.78	$170.88	$643.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.92 / $107.76 / $383.71	Professional	26	$38.92	$107.76	$383.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.86 / $38.51 / $350.03	Professional	TC	$20.86	$38.51	$350.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $118.12 / $200.29 / $247.01	Facility		$118.12	$200.29	$247.01
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $157.63 / $157.63 / $157.63	Facility	26	$157.63	$157.63	$157.63
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $89.38 / $89.38 / $89.38	Facility	TC	$89.38	$89.38	$89.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $170.88 / $200.34	Professional		$140.00	$170.88	$200.34
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $113.35 / $166.07 / $195.36	Professional		$113.35	$166.07	$195.36
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.13 / $102.13 / $116.44	Professional	26	$73.13	$102.13	$116.44
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.22 / $63.24 / $78.92	Professional	TC	$40.22	$63.24	$78.92
United Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $60.52 / $195.66	Professional		$59.78	$60.52	$195.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.75 / $38.92 / $130.76	Professional	26	$35.75	$38.92	$130.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.86 / $24.77 / $90.78	Professional	TC	$20.86	$24.77	$90.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $171.30 / $220.50 / $237.10	Professional		$171.30	$220.50	$237.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $102.10 / $131.40 / $141.30	Professional	26	$102.10	$131.40	$141.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $69.20 / $89.10 / $95.80	Professional	TC	$69.20	$89.10	$95.80