Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.82 / $39.82 / $39.82	Facility	26	$39.82	$39.82	$39.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.55 / $164.74 / $207.37	Professional		$131.55	$164.74	$207.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $52.49 / $205.20	Professional	26	$32.96	$52.49	$205.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.59 / $133.61 / $370.24	Professional	TC	$98.59	$133.61	$370.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.17 / $87.17 / $87.17	Facility	26	$87.17	$87.17	$87.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $289.26 / $373.29 / $466.62	Professional		$289.26	$373.29	$466.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.55 / $87.17 / $108.97	Professional	26	$67.55	$87.17	$108.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.71 / $286.12 / $357.65	Professional	TC	$221.71	$286.12	$357.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.88 / $143.44 / $1,140.80	Professional		$109.88	$143.44	$1,140.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $36.69 / $326.98	Professional	26	$27.23	$36.69	$326.98
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $82.65 / $106.63 / $871.18	Professional	TC	$82.65	$106.63	$871.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $152.13 / $152.13 / $152.13	Facility	26	$152.13	$152.13	$152.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.00 / $304.11 / $461.18	Professional		$199.00	$304.11	$461.18
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $182.31 / $286.22 / $337.68	Professional		$182.31	$286.22	$337.68
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $53.63 / $70.36 / $80.22	Professional	26	$53.63	$70.36	$80.22
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $139.86 / $212.52 / $257.47	Professional	TC	$139.86	$212.52	$257.47
United Facility/Professional Professional Modifier Low / Median / High Price $106.25 / $109.88 / $322.47	Professional		$106.25	$109.88	$322.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.77 / $36.69 / $91.72	Professional	26	$24.77	$36.69	$91.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.48 / $82.65 / $247.97	Professional	TC	$81.48	$82.65	$247.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $296.20 / $385.20 / $385.20	Professional		$296.20	$385.20	$385.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $70.40 / $91.50 / $91.50	Professional	26	$70.40	$91.50	$91.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $225.80 / $293.70 / $293.70	Professional	TC	$225.80	$293.70	$293.70