Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.31 / $46.31 / $46.31	Facility	26	$46.31	$46.31	$46.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.56 / $154.31 / $267.42	Professional		$133.56	$154.31	$267.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.30 / $43.18 / $66.64	Professional	26	$42.30	$43.18	$66.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.37 / $108.00 / $200.77	Professional	TC	$90.37	$108.00	$200.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.48 / $334.99 / $418.74	Professional		$252.48	$334.99	$418.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $87.24 / $109.05	Professional	26	$70.80	$87.24	$109.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.73 / $247.75 / $309.69	Professional	TC	$186.73	$247.75	$309.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.70 / $152.28 / $834.21	Professional		$103.70	$152.28	$834.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $52.72 / $70.29 / $261.89	Professional	26	$52.72	$70.29	$261.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.98 / $80.22 / $595.82	Professional	TC	$50.98	$80.22	$595.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.00 / $200.00 / $311.45	Professional		$151.00	$200.00	$311.45
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $123.69 / $227.65 / $305.33	Professional		$123.69	$227.65	$305.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.19 / $70.93 / $80.86	Professional	26	$51.19	$70.93	$80.86
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $67.98 / $167.36 / $224.47	Professional	TC	$67.98	$167.36	$224.47
United Facility/Professional Professional Modifier Low / Median / High Price $129.63 / $157.01 / $202.64	Professional		$129.63	$157.01	$202.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.60 / $54.75 / $92.25	Professional	26	$51.60	$54.75	$92.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.73 / $84.98 / $151.04	Professional	TC	$63.73	$84.98	$151.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $290.89 / $342.20 / $355.90	Professional		$290.89	$342.20	$355.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $77.00 / $90.60 / $94.30	Professional	26	$77.00	$90.60	$94.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $251.60 / $261.60	Professional	TC	$213.80	$251.60	$261.60