Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $39.86 / $39.86	Professional		$39.86	$39.86	$39.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.23 / $23.23 / $58.18	Professional	26	$23.23	$23.23	$58.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $16.64 / $16.64	Professional	TC	$16.64	$16.64	$16.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $93.54 / $144.99	Professional		$68.59	$93.54	$144.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.79 / $51.82 / $78.20	Professional	26	$38.79	$51.82	$78.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $41.40 / $66.79	Professional	TC	$22.40	$41.40	$66.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.17 / $60.98 / $118.64	Facility		$50.17	$60.98	$118.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $93.54 / $342.09	Professional		$33.07	$93.54	$342.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.35 / $58.39 / $250.96	Professional	26	$19.35	$58.39	$250.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.72 / $16.48 / $250.96	Professional	TC	$13.72	$16.48	$250.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $63.95 / $106.50 / $128.38	Facility		$63.95	$106.50	$128.38
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $78.76 / $78.76 / $78.76	Facility	26	$78.76	$78.76	$78.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $93.54 / $106.50	Professional		$64.00	$93.54	$106.50
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.49 / $73.69 / $106.09	Professional		$54.49	$73.69	$106.09
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.11 / $50.50 / $57.57	Professional	26	$36.11	$50.50	$57.57
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $26.90 / $48.52	Professional	TC	$16.30	$26.90	$48.52
United Facility/Professional Professional Modifier Low / Median / High Price $32.56 / $33.07 / $95.47	Professional		$32.56	$33.07	$95.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $19.35 / $58.39	Professional	26	$17.57	$19.35	$58.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.72 / $14.98 / $41.20	Professional	TC	$13.72	$14.98	$41.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $119.70 / $128.69	Professional		$93.00	$119.70	$128.69
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $50.50 / $65.00 / $69.90	Professional	26	$50.50	$65.00	$69.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $42.60 / $54.80 / $58.90	Professional	TC	$42.60	$54.80	$58.90