Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $231.40 / $469.92	Professional		$66.84	$231.40	$469.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.37 / $73.87 / $224.28	Professional	26	$26.37	$73.87	$224.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.40 / $161.09 / $477.90	Professional	TC	$45.40	$161.09	$477.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $168.26 / $258.35	Professional		$128.13	$168.26	$258.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.74 / $48.38 / $72.06	Professional	26	$35.74	$48.38	$72.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.39 / $120.53 / $186.30	Professional	TC	$92.39	$120.53	$186.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.84 / $102.30 / $172.25	Facility		$72.84	$102.30	$172.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.38 / $162.16 / $559.76	Professional		$56.38	$162.16	$559.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.62 / $53.23 / $173.52	Professional	26	$17.62	$53.23	$173.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.76 / $80.45 / $386.24	Professional	TC	$38.76	$80.45	$386.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $112.06 / $173.48 / $212.45	Facility		$112.06	$173.48	$212.45
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $53.19 / $53.19 / $53.19	Facility	26	$53.19	$53.19	$53.19
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $111.59 / $111.59 / $111.59	Facility	TC	$111.59	$111.59	$111.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $160.50 / $168.26 / $173.48	Professional		$160.50	$168.26	$173.48
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $87.09 / $158.91 / $186.95	Professional		$87.09	$158.91	$186.95
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.79 / $45.09 / $53.05	Professional	26	$27.79	$45.09	$53.05
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $59.30 / $110.93 / $133.91	Professional	TC	$59.30	$110.93	$133.91
United Facility/Professional Professional Modifier Low / Median / High Price $54.32 / $56.38 / $175.99	Professional		$54.32	$56.38	$175.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.18 / $17.62 / $59.14	Professional	26	$16.18	$17.62	$59.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.14 / $38.76 / $124.90	Professional	TC	$38.14	$38.76	$124.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $164.00 / $211.00 / $226.90	Professional		$164.00	$211.00	$226.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $46.50 / $59.90 / $64.40	Professional	26	$46.50	$59.90	$64.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $117.40 / $151.10 / $162.50	Professional	TC	$117.40	$151.10	$162.50