Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.48 / $78.48 / $78.48	Professional		$78.48	$78.48	$78.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $22.02 / $619.44	Professional	26	$22.02	$22.02	$619.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.46 / $56.46 / $1,915.28	Professional	TC	$56.46	$56.46	$1,915.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $192.73 / $295.26	Professional		$134.19	$192.73	$295.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $49.56 / $73.81	Professional	26	$36.61	$49.56	$73.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.17 / $143.82 / $221.45	Professional	TC	$81.17	$143.82	$221.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $132.11 / $750.04	Professional		$56.24	$132.11	$750.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $53.88 / $179.95	Professional	26	$18.05	$53.88	$179.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.31 / $76.95 / $570.15	Professional	TC	$35.31	$76.95	$570.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $110.00 / $110.00 / $110.00	Facility	26	$110.00	$110.00	$110.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $192.73 / $232.43	Professional		$134.19	$192.73	$232.43
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $159.63 / $187.81 / $219.96	Professional		$159.63	$187.81	$219.96
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $47.66 / $54.34	Professional	26	$29.91	$47.66	$54.34
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $89.12 / $140.15 / $166.72	Professional	TC	$89.12	$140.15	$166.72
United Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $68.30 / $148.13	Professional		$56.24	$68.30	$148.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.78 / $18.05 / $53.88	Professional	26	$16.78	$18.05	$53.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.19 / $51.52 / $88.28	Professional	TC	$38.19	$51.52	$88.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $187.80 / $241.60 / $259.80	Professional		$187.80	$241.60	$259.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $47.70 / $61.30 / $65.90	Professional	26	$47.70	$61.30	$65.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $140.10 / $180.30 / $193.90	Professional	TC	$140.10	$180.30	$193.90