Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.10 / $126.10 / $378.12	Professional		$126.10	$126.10	$378.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.86 / $125.49 / $132.61	Professional	26	$28.86	$125.49	$132.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.24 / $97.24 / $348.88	Professional	TC	$97.24	$97.24	$348.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.23 / $301.01 / $462.22	Professional		$229.23	$301.01	$462.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.81 / $66.08 / $98.42	Professional	26	$48.81	$66.08	$98.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $180.42 / $235.80 / $363.80	Professional	TC	$180.42	$235.80	$363.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.44 / $195.14 / $299.02	Facility		$126.44	$195.14	$299.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.96 / $212.53 / $1,081.50	Professional		$104.96	$212.53	$1,081.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.90 / $77.22 / $235.79	Professional	26	$23.90	$77.22	$235.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $81.06 / $135.31 / $845.71	Professional	TC	$81.06	$135.31	$845.71
Midlands Facility/Professional Facility Modifier Low / Median / High Price $199.89 / $334.92 / $403.28	Facility		$199.89	$334.92	$403.28
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $97.66 / $97.66 / $97.66	Facility	26	$97.66	$97.66	$97.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $294.45 / $301.01 / $334.92	Professional		$294.45	$301.01	$334.92
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $169.77 / $284.30 / $334.45	Professional		$169.77	$284.30	$334.45
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.06 / $64.06 / $72.45	Professional	26	$48.06	$64.06	$72.45
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $122.98 / $222.71 / $261.99	Professional	TC	$122.98	$222.71	$261.99
United Facility/Professional Professional Modifier Low / Median / High Price $103.66 / $104.96 / $348.26	Professional		$103.66	$104.96	$348.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.17 / $23.90 / $80.95	Professional	26	$22.17	$23.90	$80.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.06 / $81.48 / $267.30	Professional	TC	$81.06	$81.48	$267.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $293.30 / $377.40 / $405.80	Professional		$293.30	$377.40	$405.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $63.50 / $81.80 / $87.90	Professional	26	$63.50	$81.80	$87.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $229.80 / $295.70 / $317.89	Professional	TC	$229.80	$295.70	$317.89