Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $398.11	Professional		$100.00	$181.97	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $63.10 / $660.69	Professional	26	$8.13	$63.10	$660.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $74.13 / $120.23	Professional	TC	$57.54	$74.13	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $218.78 / $323.59	Professional		$158.49	$218.78	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $107.15	Professional	26	$52.48	$72.44	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $141.25 / $218.78	Professional	TC	$104.71	$141.25	$218.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $147.91 / $346.74	Facility		$134.90	$147.91	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $213.80 / $758.58	Professional		$75.86	$213.80	$758.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $70.79 / $309.03	Professional	26	$26.30	$70.79	$309.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $75.86 / $512.86	Professional	TC	$50.12	$75.86	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $218.78 / $218.78	Professional		$208.93	$218.78	$218.78
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $77.62 / $77.62	Professional	26	$69.18	$77.62	$77.62
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $141.25 / $141.25	Professional	TC	$138.04	$141.25	$141.25
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $239.88	Professional		$154.88	$218.78	$239.88
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $77.62 / $89.13	Professional	26	$57.54	$77.62	$89.13
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $134.90 / $154.88	Professional	TC	$89.13	$134.90	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $281.84	Professional		$72.44	$112.20	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $42.66 / $112.20	Professional	26	$23.99	$42.66	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $67.61 / $169.82	Professional	TC	$47.86	$67.61	$169.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $263.03 / $281.84	Professional		$204.17	$263.03	$281.84
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $87.10 / $93.33	Professional	26	$67.61	$87.10	$93.33
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $173.78 / $186.21	Professional	TC	$134.90	$173.78	$186.21