Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $275.42 / $346.74	Professional		$95.50	$275.42	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $64.57 / $309.03	Professional	26	$32.36	$64.57	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $173.78 / $204.17	Professional	TC	$63.10	$173.78	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $194.98 / $309.03	Professional		$147.91	$194.98	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $61.66 / $91.20	Professional	26	$43.65	$61.66	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $138.04 / $218.78	Professional	TC	$104.71	$138.04	$218.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $120.23 / $234.42	Facility		$97.72	$120.23	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $190.55 / $660.69	Professional		$66.07	$190.55	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $64.57 / $275.42	Professional	26	$21.88	$64.57	$275.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $63.10 / $426.58	Professional	TC	$41.69	$63.10	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $194.98	Professional		$181.97	$181.97	$194.98
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $64.57 / $64.57	Professional	26	$58.88	$64.57	$64.57
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $117.49 / $138.04	Professional	TC	$117.49	$117.49	$138.04
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $218.78	Professional		$131.83	$186.21	$218.78
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $63.10 / $66.07	Professional	26	$48.98	$63.10	$66.07
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $128.82 / $151.36	Professional	TC	$81.28	$128.82	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $213.80	Professional		$63.10	$87.10	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $29.51 / $74.13	Professional	26	$19.95	$29.51	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $56.23 / $144.54	Professional	TC	$41.69	$56.23	$144.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $263.03	Professional		$190.55	$245.47	$263.03
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $79.43	Professional	26	$57.54	$74.13	$79.43
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $173.78 / $186.21	Professional	TC	$134.90	$173.78	$186.21