Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.36 / $41.36 / $277.32	Facility		$41.36	$41.36	$277.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.01 / $23.01 / $23.01	Facility	26	$23.01	$23.01	$23.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.35 / $278.42 / $408.14	Facility	TC	$18.35	$278.42	$408.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.63 / $75.25 / $188.72	Professional		$37.63	$75.25	$188.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.67 / $22.01 / $56.96	Professional	26	$19.67	$22.01	$56.96
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.82 / $18.82 / $20.68	Professional	52	$18.82	$18.82	$20.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.01 / $53.22 / $120.15	Professional	TC	$16.01	$53.22	$120.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $77.88 / $95.96	Professional		$62.30	$77.88	$95.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $42.57 / $53.21	Professional	26	$34.54	$42.57	$53.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.86 / $34.69 / $42.75	Professional	TC	$28.86	$34.69	$42.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.33 / $69.90 / $168.08	Facility		$48.33	$69.90	$168.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $86.22 / $402.37	Professional		$56.73	$86.22	$402.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.44 / $35.25 / $130.60	Professional	26	$26.44	$35.25	$130.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $57.58 / $284.52	Professional	TC	$29.49	$57.58	$284.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $78.53 / $90.66 / $116.12	Facility		$78.53	$90.66	$116.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $96.83 / $137.76	Professional		$81.00	$96.83	$137.76
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $53.05 / $71.16 / $128.80	Professional		$53.05	$71.16	$128.80
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.70 / $34.61 / $39.46	Professional	26	$26.70	$34.61	$39.46
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.63 / $31.70 / $89.35	Professional	TC	$23.63	$31.70	$89.35
United Facility/Professional Professional Modifier Low / Median / High Price $46.19 / $59.53 / $132.63	Professional		$46.19	$59.53	$132.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.39 / $27.24 / $44.06	Professional	26	$25.39	$27.24	$44.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.80 / $29.99 / $93.01	Professional	TC	$20.80	$29.99	$93.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $67.80 / $79.80 / $82.90	Professional		$67.80	$79.80	$82.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $37.60 / $44.20 / $46.00	Professional	26	$37.60	$44.20	$46.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $35.50 / $36.90	Professional	TC	$30.20	$35.50	$36.90