Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $41.85 / $41.85	Professional		$41.85	$41.85	$41.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.50 / $28.50 / $28.50	Professional	26	$28.50	$28.50	$28.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.35 / $13.35 / $13.35	Professional	TC	$13.35	$13.35	$13.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $98.56 / $147.63	Professional		$73.20	$98.56	$147.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.50 / $64.31 / $95.78	Professional	26	$47.50	$64.31	$95.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $33.77 / $51.85	Professional	TC	$25.71	$33.77	$51.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.51 / $98.56 / $353.10	Professional		$34.51	$98.56	$353.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.68 / $63.38 / $231.59	Professional	26	$23.68	$63.38	$231.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.83 / $22.09 / $121.51	Professional	TC	$10.83	$22.09	$121.51
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $98.90 / $98.90 / $98.90	Facility	26	$98.90	$98.90	$98.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $97.24 / $124.37	Professional		$84.00	$97.24	$124.37
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $70.84 / $94.76 / $108.50	Professional		$70.84	$94.76	$108.50
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $44.33 / $60.34 / $70.51	Professional	26	$44.33	$60.34	$70.51
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.51 / $33.14 / $44.10	Professional	TC	$26.51	$33.14	$44.10
United Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $34.51 / $119.28	Professional		$33.15	$34.51	$119.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.57 / $23.68 / $80.23	Professional	26	$21.57	$23.68	$80.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.83 / $11.59 / $55.30	Professional	TC	$10.83	$11.59	$55.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.80 / $121.90 / $131.10	Professional		$94.80	$121.90	$131.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $61.80 / $79.59 / $85.60	Professional	26	$61.80	$79.59	$85.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $32.90 / $42.30 / $45.50	Professional	TC	$32.90	$42.30	$45.50