Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.19 / $135.82 / $170.06	Professional		$117.19	$135.82	$170.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.25 / $14.87 / $20.73	Professional	26	$14.25	$14.87	$20.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.75 / $120.95 / $149.33	Professional	TC	$102.75	$120.95	$149.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.73 / $238.56 / $349.80	Professional		$118.73	$238.56	$349.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $27.31 / $37.32	Professional	26	$12.67	$27.31	$37.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.07 / $205.94 / $312.48	Professional	TC	$106.07	$205.94	$312.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $186.50 / $800.25	Professional		$96.63	$186.50	$800.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $26.70 / $135.38	Professional	26	$13.19	$26.70	$135.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.44 / $159.80 / $706.26	Professional	TC	$83.44	$159.80	$706.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $118.68 / $196.73 / $266.58	Professional		$118.68	$196.73	$266.58
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $97.36 / $155.54 / $256.17	Professional		$97.36	$155.54	$256.17
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $21.22 / $28.46	Professional	26	$17.36	$21.22	$28.46
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $79.98 / $136.22 / $227.71	Professional	TC	$79.98	$136.22	$227.71
United Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $145.72 / $237.30	Professional		$96.63	$145.72	$237.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.64 / $17.84 / $32.11	Professional	26	$12.64	$17.84	$32.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.44 / $116.92 / $206.20	Professional	TC	$83.44	$116.92	$206.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $178.80 / $224.70 / $233.70	Professional		$178.80	$224.70	$233.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $25.00 / $26.00	Professional	26	$19.89	$25.00	$26.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $158.90 / $199.70 / $207.70	Professional	TC	$158.90	$199.70	$207.70