Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $114.82 / $218.78	Professional		$100.00	$114.82	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $77.62 / $102.33	Professional	26	$70.79	$77.62	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $32.36 / $44.67	Professional	TC	$25.70	$32.36	$44.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $177.83 / $257.04	Professional		$93.33	$177.83	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $131.83 / $186.21	Professional	26	$67.61	$131.83	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $50.12 / $72.44	Professional	TC	$25.70	$50.12	$72.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $169.82 / $707.95	Professional		$93.33	$169.82	$707.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $117.49 / $489.78	Professional	26	$69.18	$117.49	$489.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $38.02 / $213.80	Professional	TC	$22.39	$38.02	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $229.09 / $229.09	Professional		$204.17	$229.09	$229.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $177.83 / $177.83	Professional	26	$158.49	$177.83	$177.83
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $52.48 / $52.48	Professional	TC	$45.71	$52.48	$52.48
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $204.17	Professional		$123.03	$165.96	$204.17
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $123.03 / $147.91	Professional	26	$89.13	$123.03	$147.91
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $39.81 / $58.88	Professional	TC	$32.36	$39.81	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $218.78	Professional		$91.20	$123.03	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $95.50 / $158.49	Professional	26	$67.61	$95.50	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $31.62 / $56.23	Professional	TC	$23.99	$31.62	$56.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $186.21	Professional		$141.25	$177.83	$186.21
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $128.82 / $134.90	Professional	26	$102.33	$128.82	$134.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $48.98 / $51.29	Professional	TC	$38.90	$48.98	$51.29