Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $112.20 / $354.81	Professional		$70.79	$112.20	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $25.70 / $616.60	Professional	26	$21.88	$25.70	$616.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $85.11 / $1,905.46	Professional	TC	$44.67	$85.11	$1,905.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $302.00	Professional		$134.90	$190.55	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $51.29 / $75.86	Professional	26	$36.31	$51.29	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $144.54 / $229.09	Professional	TC	$81.28	$144.54	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $87.10 / $758.58	Professional		$56.23	$87.10	$758.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $29.51 / $181.97	Professional	26	$18.20	$29.51	$181.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $57.54 / $575.44	Professional	TC	$35.48	$57.54	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $190.55	Professional		$134.90	$134.90	$190.55
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $52.48 / $52.48	Professional	26	$48.98	$52.48	$52.48
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $81.28 / $144.54	Professional	TC	$81.28	$81.28	$144.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $186.21 / $213.80	Professional		$117.49	$186.21	$213.80
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $51.29 / $54.95	Professional	26	$40.74	$51.29	$54.95
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $151.36 / $158.49	Professional	TC	$74.13	$151.36	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.61 / $199.53	Professional		$56.23	$67.61	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $23.99 / $60.26	Professional	26	$16.60	$23.99	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $51.29 / $147.91	Professional	TC	$38.02	$51.29	$147.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $239.88 / $257.04	Professional		$186.21	$239.88	$257.04
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $66.07	Professional	26	$47.86	$61.66	$66.07
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $181.97 / $194.98	Professional	TC	$141.25	$181.97	$194.98