Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $60.26 / $93.33	Facility	26	$60.26	$60.26	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $309.03	Professional		$83.18	$123.03	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $77.62 / $177.83	Professional	26	$53.70	$77.62	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $52.48 / $120.23	Professional	TC	$32.36	$52.48	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $257.04	Professional		$173.78	$208.93	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $117.49 / $144.54	Professional	26	$100.00	$117.49	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $91.20 / $114.82	Professional	TC	$72.44	$91.20	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $158.49 / $741.31	Professional		$87.10	$158.49	$741.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $102.33 / $354.81	Professional	26	$57.54	$102.33	$354.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $47.86 / $288.40	Professional	TC	$28.84	$47.86	$288.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $186.21 / $239.88	Professional		$165.96	$186.21	$239.88
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $128.82 / $138.04	Professional	26	$114.82	$128.82	$138.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $56.23 / $102.33	Professional	TC	$48.98	$56.23	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $162.18 / $162.18	Professional		$87.10	$162.18	$162.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $120.23 / $120.23	Professional	26	$60.26	$120.23	$120.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $43.65 / $43.65	Professional	TC	$26.30	$43.65	$43.65
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $190.55	Professional		$102.33	$138.04	$190.55
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $91.20 / $107.15	Professional	26	$61.66	$91.20	$107.15
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $58.88 / $81.28	Professional	TC	$36.31	$58.88	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $158.49 / $229.09	Professional		$89.13	$158.49	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $104.71 / $151.36	Professional	26	$57.54	$104.71	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $50.12 / $85.11	Professional	TC	$28.84	$50.12	$85.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $199.53 / $234.42	Professional		$194.98	$199.53	$234.42
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $114.82 / $134.90	Professional	26	$109.65	$114.82	$134.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $87.10 / $102.33	Professional	TC	$83.18	$87.10	$102.33