Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.09 / $45.09 / $45.09	Facility	26	$45.09	$45.09	$45.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.40 / $78.55 / $115.62	Professional		$71.40	$78.55	$115.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $45.22 / $63.09	Professional	26	$39.65	$45.22	$63.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.17 / $28.79 / $49.50	Professional	TC	$26.17	$28.79	$49.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.47 / $173.08 / $216.35	Professional		$140.47	$173.08	$216.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.78 / $84.96 / $104.69	Professional	26	$70.78	$84.96	$104.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.50 / $89.33 / $111.66	Professional	TC	$72.50	$89.33	$111.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.39 / $138.16 / $676.25	Professional		$74.39	$138.16	$676.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $78.03 / $271.97	Professional	26	$45.29	$78.03	$271.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.16 / $49.29 / $290.20	Professional	TC	$28.16	$49.29	$290.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.76 / $134.84 / $188.53	Professional		$81.76	$134.84	$188.53
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $86.07 / $116.65 / $159.78	Professional		$86.07	$116.65	$159.78
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.01 / $66.54 / $78.27	Professional	26	$48.01	$66.54	$78.27
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $35.14 / $59.14 / $81.51	Professional	TC	$35.14	$59.14	$81.51
United Facility/Professional Professional Modifier Low / Median / High Price $68.76 / $132.35 / $166.44	Professional		$68.76	$132.35	$166.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $75.84 / $94.25	Professional	26	$45.29	$75.84	$94.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.13 / $60.78 / $88.38	Professional	TC	$29.13	$60.78	$88.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $164.80 / $171.40 / $201.70	Professional		$164.80	$171.40	$201.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $80.70 / $84.00 / $98.80	Professional	26	$80.70	$84.00	$98.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $84.10 / $87.40 / $102.90	Professional	TC	$84.10	$87.40	$102.90