Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $229.09	Professional		$97.72	$134.90	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.02 / $64.57	Professional	26	$30.90	$38.02	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $97.72 / $165.96	Professional	TC	$66.07	$97.72	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $407.38	Professional		$199.53	$263.03	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $74.13 / $112.20	Professional	26	$53.70	$74.13	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $302.00	Professional	TC	$141.25	$190.55	$302.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $1,071.52	Professional		$79.43	$123.03	$1,071.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $41.69 / $389.05	Professional	26	$25.70	$41.69	$389.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $81.28 / $794.33	Professional	TC	$53.70	$81.28	$794.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $263.03	Professional		$218.78	$218.78	$263.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $77.62 / $77.62	Professional	26	$72.44	$77.62	$77.62
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $141.25 / $190.55	Professional	TC	$141.25	$141.25	$190.55
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $331.13	Professional		$169.82	$275.42	$331.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $77.62 / $93.33	Professional	26	$58.88	$77.62	$93.33
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $199.53 / $239.88	Professional	TC	$107.15	$199.53	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $269.15	Professional		$79.43	$93.33	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $85.11	Professional	26	$24.55	$33.88	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $64.57 / $199.53	Professional	TC	$53.70	$64.57	$199.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $354.81	Professional		$251.19	$323.59	$354.81
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $95.50	Professional	26	$69.18	$89.13	$95.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $234.42 / $257.04	Professional	TC	$181.97	$234.42	$257.04