Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $87.10 / $141.25	Professional		$70.79	$87.10	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $60.26 / $223.87	Professional	26	$52.48	$60.26	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.20 / $47.86	Professional	TC	$22.91	$30.20	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $245.47	Professional		$120.23	$158.49	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $107.15 / $162.18	Professional	26	$77.62	$107.15	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $54.95 / $85.11	Professional	TC	$41.69	$54.95	$85.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $588.84	Professional		$54.95	$87.10	$588.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $63.10 / $380.19	Professional	26	$38.90	$63.10	$380.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $204.17	Professional	TC	$15.85	$23.99	$204.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $114.82 / $114.82	Professional	26	$104.71	$114.82	$114.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $42.66 / $54.95	Professional	TC	$42.66	$42.66	$54.95
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $177.83	Professional		$117.49	$158.49	$177.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $104.71 / $114.82	Professional	26	$77.62	$104.71	$114.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $56.23 / $69.18	Professional	TC	$45.71	$56.23	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $75.86 / $190.55	Professional		$54.95	$75.86	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $131.83	Professional	26	$35.48	$52.48	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $57.54	Professional	TC	$15.85	$22.91	$57.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $199.53 / $213.80	Professional		$154.88	$199.53	$213.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $131.83 / $141.25	Professional	26	$102.33	$131.83	$141.25
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $69.18 / $74.13	Professional	TC	$53.70	$69.18	$74.13