Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.67 / $97.67 / $97.67	Professional		$97.67	$97.67	$97.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $31.37 / $31.37	Professional	26	$31.37	$31.37	$31.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.30 / $66.30 / $66.30	Professional	TC	$66.30	$66.30	$66.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.85 / $260.26 / $398.95	Professional		$197.85	$260.26	$398.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.60 / $72.56 / $108.09	Professional	26	$53.60	$72.56	$108.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.72 / $188.64 / $290.87	Professional	TC	$142.72	$188.64	$290.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $219.95 / $1,070.24	Professional		$79.93	$219.95	$1,070.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.85 / $75.83 / $390.67	Professional	26	$25.85	$75.83	$390.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $54.08 / $114.87 / $793.60	Professional	TC	$54.08	$114.87	$793.60
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $164.60 / $164.60 / $164.60	Facility	26	$164.60	$164.60	$164.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $206.00 / $260.26 / $302.61	Professional		$206.00	$260.26	$302.61
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $143.68 / $253.63 / $340.31	Professional		$143.68	$253.63	$340.31
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $50.82 / $69.79 / $97.70	Professional	26	$50.82	$69.79	$97.70
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $102.68 / $183.84 / $242.46	Professional	TC	$102.68	$183.84	$242.46
United Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $88.68 / $236.00	Professional		$79.93	$88.68	$236.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.37 / $25.85 / $84.26	Professional	26	$24.37	$25.85	$84.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.08 / $64.31 / $136.57	Professional	TC	$54.08	$64.31	$136.57
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $253.60 / $326.30 / $350.90	Professional		$253.60	$326.30	$350.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.80 / $89.80 / $96.60	Professional	26	$69.80	$89.80	$96.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $183.80 / $236.50 / $254.30	Professional	TC	$183.80	$236.50	$254.30