Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.53 / $82.53 / $82.53	Professional		$82.53	$82.53	$82.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.59 / $25.59 / $25.59	Professional	26	$25.59	$25.59	$25.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.94 / $56.94 / $56.94	Professional	TC	$56.94	$56.94	$56.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.25 / $190.39 / $290.87	Professional		$144.25	$190.39	$290.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.84 / $56.64 / $84.36	Professional	26	$41.84	$56.64	$84.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.41 / $134.50 / $206.51	Professional	TC	$102.41	$134.50	$206.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.80 / $192.37 / $1,210.67	Professional		$68.80	$192.37	$1,210.67
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.30 / $64.86 / $360.79	Professional	26	$21.30	$64.86	$360.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $47.50 / $127.51 / $914.18	Professional	TC	$47.50	$127.51	$914.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $160.87 / $160.87 / $160.87	Facility	26	$160.87	$160.87	$160.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $188.77 / $190.39 / $350.00	Professional		$188.77	$190.39	$350.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $185.54 / $375.92	Professional		$128.77	$185.54	$375.92
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.50 / $57.44 / $90.27	Professional	26	$43.50	$57.44	$90.27
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $86.24 / $131.07 / $285.66	Professional	TC	$86.24	$131.07	$285.66
United Facility/Professional Professional Modifier Low / Median / High Price $66.91 / $68.80 / $213.74	Professional		$66.91	$68.80	$213.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.18 / $21.30 / $72.06	Professional	26	$19.18	$21.30	$72.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.50 / $47.73 / $141.68	Professional	TC	$47.50	$47.73	$141.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.50 / $238.70 / $256.70	Professional		$185.50	$238.70	$256.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $54.50 / $70.09 / $75.40	Professional	26	$54.50	$70.09	$75.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $131.10 / $168.60 / $181.30	Professional	TC	$131.10	$168.60	$181.30