Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.83 / $60.83 / $60.83	Facility	26	$60.83	$60.83	$60.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $92.48 / $129.06	Professional		$83.62	$92.48	$129.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.04 / $56.72 / $107.00	Professional	26	$55.04	$56.72	$107.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $29.58 / $50.73	Professional	TC	$26.89	$29.58	$50.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.69 / $201.69 / $252.12	Professional		$163.69	$201.69	$252.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.55 / $114.70 / $141.32	Professional	26	$95.55	$114.70	$141.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.93 / $88.63 / $110.79	Professional	TC	$71.93	$88.63	$110.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.14 / $165.04 / $746.58	Professional		$89.14	$165.04	$746.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.99 / $105.79 / $352.29	Professional	26	$57.99	$105.79	$352.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $50.04 / $288.04	Professional	TC	$28.59	$50.04	$288.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.61 / $164.27 / $224.98	Professional		$97.61	$164.27	$224.98
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $138.90 / $186.95	Professional		$99.97	$138.90	$186.95
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $64.58 / $90.18 / $106.09	Professional	26	$64.58	$90.18	$106.09
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $35.94 / $58.68 / $80.86	Professional	TC	$35.94	$58.68	$80.86
United Facility/Professional Professional Modifier Low / Median / High Price $79.76 / $157.86 / $194.17	Professional		$79.76	$157.86	$194.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.92 / $102.76 / $123.42	Professional	26	$56.92	$102.76	$123.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.83 / $55.10 / $70.75	Professional	TC	$28.83	$55.10	$70.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $192.80 / $200.50 / $235.90	Professional		$192.80	$200.50	$235.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $109.40 / $113.80 / $133.90	Professional	26	$109.40	$113.80	$133.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $83.40 / $86.70 / $102.00	Professional	TC	$83.40	$86.70	$102.00