Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.34 / $40.34 / $40.34	Facility	26	$40.34	$40.34	$40.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.28 / $79.94 / $308.75	Professional		$61.28	$79.94	$308.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.72 / $38.71 / $90.00	Professional	26	$34.72	$38.71	$90.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $37.85 / $108.58	Professional	TC	$22.57	$37.85	$108.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.54 / $163.31 / $204.14	Professional		$132.54	$163.31	$204.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.70 / $76.45 / $94.22	Professional	26	$63.70	$76.45	$94.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.37 / $87.94 / $109.92	Professional	TC	$71.37	$87.94	$109.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.19 / $122.54 / $568.04	Professional		$64.19	$122.54	$568.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $70.22 / $236.22	Professional	26	$38.47	$70.22	$236.22
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.86 / $41.75 / $285.88	Professional	TC	$23.86	$41.75	$285.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.41 / $125.00 / $208.57	Professional		$69.41	$125.00	$208.57
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $80.65 / $108.74 / $150.08	Professional		$80.65	$108.74	$150.08
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.79 / $59.39 / $69.87	Professional	26	$42.79	$59.39	$69.87
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.00 / $58.22 / $80.22	Professional	TC	$32.00	$58.22	$80.22
United Facility/Professional Professional Modifier Low / Median / High Price $64.19 / $122.54 / $156.46	Professional		$64.19	$122.54	$156.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $69.63 / $99.83	Professional	26	$33.75	$69.63	$99.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.92 / $59.51 / $70.01	Professional	TC	$25.92	$59.51	$70.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $154.80 / $161.00 / $189.40	Professional		$154.80	$161.00	$189.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $74.90 / $88.20	Professional	26	$72.09	$74.90	$88.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $82.70 / $86.00 / $101.20	Professional	TC	$82.70	$86.00	$101.20