Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.58 / $69.78 / $182.70	Professional		$58.58	$69.78	$182.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $26.87 / $79.37	Professional	26	$25.55	$26.87	$79.37
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.69 / $32.36 / $43.93	Professional	52	$23.69	$32.36	$43.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.56 / $37.85 / $49.26	Professional	TC	$26.56	$37.85	$49.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.27 / $120.43 / $165.79	Professional		$56.27	$120.43	$165.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $50.71 / $68.56	Professional	26	$23.28	$50.71	$68.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.00 / $70.62 / $97.22	Professional	TC	$33.00	$70.62	$97.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.01 / $92.97 / $122.38	Facility		$55.01	$92.97	$122.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.57 / $90.00 / $396.63	Professional		$57.57	$90.00	$396.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $34.90 / $167.21	Professional	26	$23.93	$34.90	$167.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.24 / $44.83 / $257.11	Professional	TC	$31.24	$44.83	$257.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $122.77 / $134.00 / $154.38	Facility		$122.77	$134.00	$154.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.75 / $122.00 / $143.65	Professional		$75.75	$122.00	$143.65
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $75.28 / $92.78 / $123.71	Professional		$75.28	$92.78	$123.71
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.62 / $34.15 / $51.11	Professional	26	$30.62	$34.15	$51.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $43.51 / $55.48 / $72.29	Professional	TC	$43.51	$55.48	$72.29
United Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $75.90 / $95.33	Professional		$54.60	$75.90	$95.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.36 / $31.56 / $43.20	Professional	26	$22.36	$31.56	$43.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.67 / $41.28 / $52.13	Professional	TC	$30.67	$41.28	$52.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.30 / $116.50 / $121.10	Professional		$85.30	$116.50	$121.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $35.70 / $48.70 / $50.60	Professional	26	$35.70	$48.70	$50.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $49.70 / $67.80 / $70.50	Professional	TC	$49.70	$67.80	$70.50