Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.49 / $31.49 / $31.49	Facility	26	$31.49	$31.49	$31.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $99.23 / $131.24	Professional		$88.93	$99.23	$131.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.89 / $31.49 / $120.60	Professional	26	$24.89	$31.49	$120.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.06 / $76.12 / $275.89	Professional	TC	$69.06	$76.12	$275.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.89 / $68.89 / $68.89	Facility	26	$68.89	$68.89	$68.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.09 / $276.27 / $345.35	Professional		$214.09	$276.27	$345.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.39 / $68.89 / $86.12	Professional	26	$53.39	$68.89	$86.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.69 / $207.39 / $259.23	Professional	TC	$160.69	$207.39	$259.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.96 / $106.00 / $275.75	Professional		$83.96	$106.00	$275.75
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $28.94 / $212.17	Professional	26	$21.52	$28.94	$212.17
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $62.44 / $77.06 / $663.40	Professional	TC	$62.44	$77.06	$663.40
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $91.38 / $91.38 / $91.38	Facility	26	$91.38	$91.38	$91.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $195.50 / $227.89 / $349.49	Professional		$195.50	$227.89	$349.49
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $139.81 / $212.81 / $250.35	Professional		$139.81	$212.81	$250.35
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.22 / $53.89 / $63.40	Professional	26	$38.22	$53.89	$63.40
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $104.37 / $158.91 / $186.95	Professional	TC	$104.37	$158.91	$186.95
United Facility/Professional Professional Modifier Low / Median / High Price $79.89 / $83.96 / $238.50	Professional		$79.89	$83.96	$238.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $21.65 / $64.55	Professional	26	$19.57	$21.65	$64.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.32 / $62.44 / $94.58	Professional	TC	$60.32	$62.44	$94.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $219.60 / $285.60 / $285.60	Professional		$219.60	$285.60	$285.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $55.60 / $72.30 / $72.30	Professional	26	$55.60	$72.30	$72.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $164.00 / $213.30 / $213.30	Professional	TC	$164.00	$213.30	$213.30