Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $69.18 / $165.96	Professional		$51.29	$69.18	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.30 / $61.66	Professional	26	$20.89	$26.30	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $52.48	Professional	TC	$25.70	$33.88	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.46 / $30.20 / $42.66	Facility	26	$6.46	$30.20	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $112.20 / $154.88	Professional		$56.23	$112.20	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $46.77 / $64.57	Professional	26	$23.44	$46.77	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $66.07 / $91.20	Professional	TC	$33.11	$66.07	$91.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $93.33 / $123.03	Facility		$51.29	$93.33	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $95.50 / $398.11	Professional		$57.54	$95.50	$398.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $37.15 / $165.96	Professional	26	$23.99	$37.15	$165.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $45.71 / $257.04	Professional	TC	$30.90	$45.71	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $144.54 / $144.54	Professional		$123.03	$144.54	$144.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $60.26 / $60.26	Professional	26	$54.95	$60.26	$60.26
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $83.18 / $83.18	Professional	TC	$67.61	$83.18	$83.18
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $123.03	Professional		$74.13	$93.33	$123.03
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.02 / $51.29	Professional	26	$30.90	$38.02	$51.29
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $60.26 / $72.44	Professional	TC	$42.66	$60.26	$72.44
United Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $28.84 / $43.65	Facility		$15.14	$28.84	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $72.44 / $128.82	Professional		$53.70	$72.44	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $32.36 / $53.70	Professional	26	$21.88	$32.36	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $42.66 / $74.13	Professional	TC	$30.90	$42.66	$74.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $120.23	Professional		$85.11	$117.49	$120.23
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $48.98 / $50.12	Professional	26	$35.48	$48.98	$50.12
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $67.61 / $70.79	Professional	TC	$50.12	$67.61	$70.79