Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.14 / $84.14 / $84.14	Professional		$84.14	$84.14	$84.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.53 / $24.53 / $24.53	Professional	26	$24.53	$24.53	$24.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.61 / $59.61 / $59.61	Professional	TC	$59.61	$59.61	$59.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.45 / $228.24 / $349.74	Professional		$173.45	$228.24	$349.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.14 / $58.41 / $87.00	Professional	26	$43.14	$58.41	$87.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.30 / $170.60 / $262.75	Professional	TC	$130.30	$170.60	$262.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.67 / $134.06 / $730.19	Professional		$69.67	$134.06	$730.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.22 / $48.58 / $200.25	Professional	26	$20.22	$48.58	$200.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.45 / $85.48 / $531.07	Professional	TC	$49.45	$85.48	$531.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $84.16 / $84.16 / $84.16	Facility	26	$84.16	$84.16	$84.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $192.20 / $228.24 / $241.23	Professional		$192.20	$228.24	$241.23
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $117.83 / $215.56 / $253.58	Professional		$117.83	$215.56	$253.58
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.53 / $49.55 / $64.04	Professional	26	$32.53	$49.55	$64.04
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $77.79 / $161.12 / $189.54	Professional	TC	$77.79	$161.12	$189.54
United Facility/Professional Professional Modifier Low / Median / High Price $69.67 / $76.90 / $215.90	Professional		$69.67	$76.90	$215.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $20.22 / $66.31	Professional	26	$19.38	$20.22	$66.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.45 / $57.52 / $149.58	Professional	TC	$49.45	$57.52	$149.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $222.40 / $286.20 / $307.70	Professional		$222.40	$286.20	$307.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $56.20 / $72.30 / $77.70	Professional	26	$56.20	$72.30	$77.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $166.20 / $213.90 / $230.00	Professional	TC	$166.20	$213.90	$230.00