Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.76 / $70.40 / $170.84	Professional		$59.76	$70.40	$170.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $37.15 / $52.87	Professional	26	$35.22	$37.15	$52.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $27.90 / $36.77	Professional	TC	$19.88	$27.90	$36.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.57 / $121.64 / $166.66	Professional		$56.57	$121.64	$166.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.11 / $69.95 / $94.61	Professional	26	$32.11	$69.95	$94.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.45 / $51.96 / $72.04	Professional	TC	$24.45	$51.96	$72.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.76 / $80.18 / $396.08	Professional		$55.76	$80.18	$396.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.07 / $47.99 / $347.34	Professional	26	$33.07	$47.99	$347.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.69 / $32.19 / $166.53	Professional	TC	$22.69	$32.19	$166.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.34 / $120.45 / $143.65	Professional		$77.34	$120.45	$143.65
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $67.64 / $80.03 / $123.56	Professional		$67.64	$80.03	$123.56
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.31 / $46.94 / $70.51	Professional	26	$42.31	$46.94	$70.51
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $33.35 / $53.05	Professional	TC	$25.14	$33.35	$53.05
United Facility/Professional Professional Modifier Low / Median / High Price $54.91 / $72.67 / $115.45	Professional		$54.91	$72.67	$115.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.84 / $44.60 / $59.43	Professional	26	$30.84	$44.60	$59.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.08 / $28.67 / $41.50	Professional	TC	$22.08	$28.67	$41.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $86.20 / $117.70 / $122.40	Professional		$86.20	$117.70	$122.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $49.20 / $67.20 / $69.90	Professional	26	$49.20	$67.20	$69.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.00 / $50.50 / $52.60	Professional	TC	$37.00	$50.50	$52.60