Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.19 / $89.19 / $376.20	Professional		$89.19	$89.19	$376.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $40.79 / $658.60	Professional	26	$8.17	$40.79	$658.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.43 / $57.43 / $57.43	Professional	TC	$57.43	$57.43	$57.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.76 / $213.58 / $318.11	Professional		$157.76	$213.58	$318.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.30 / $70.80 / $105.45	Professional	26	$52.30	$70.80	$105.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.46 / $142.12 / $212.66	Professional	TC	$105.46	$142.12	$212.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $135.61 / $147.90 / $349.76	Facility		$135.61	$147.90	$349.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.16 / $214.78 / $764.45	Professional		$76.16	$214.78	$764.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $70.42 / $310.87	Professional	26	$26.28	$70.42	$310.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.88 / $80.12 / $507.20	Professional	TC	$49.88	$80.12	$507.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $138.65 / $237.14 / $321.12	Facility		$138.65	$237.14	$321.12
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $137.11 / $137.11 / $137.11	Facility	26	$137.11	$137.11	$137.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $121.00 / $207.86 / $259.52	Professional		$121.00	$207.86	$259.52
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $155.40 / $196.31 / $230.94	Professional		$155.40	$196.31	$230.94
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $65.34 / $73.75 / $89.93	Professional	26	$65.34	$73.75	$89.93
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $90.04 / $130.33 / $153.32	Professional	TC	$90.04	$130.33	$153.32
United Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $76.16 / $337.06	Professional		$72.09	$76.16	$337.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $26.28 / $113.98	Professional	26	$23.97	$26.28	$113.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.13 / $49.88 / $168.96	Professional	TC	$48.13	$49.88	$168.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $202.60 / $260.60 / $280.20	Professional		$202.60	$260.60	$280.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $68.09 / $87.60 / $94.20	Professional	26	$68.09	$87.60	$94.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $134.50 / $173.00 / $186.00	Professional	TC	$134.50	$173.00	$186.00