Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.06 / $66.06 / $66.06	Facility	26	$66.06	$66.06	$66.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.18 / $103.49 / $151.28	Professional		$93.18	$103.49	$151.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.84 / $62.67 / $137.94	Professional	26	$59.84	$62.67	$137.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.51 / $41.35 / $106.20	Professional	TC	$30.51	$41.35	$106.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.33 / $217.74 / $272.18	Professional		$178.33	$217.74	$272.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.80 / $124.61 / $153.54	Professional	26	$103.80	$124.61	$153.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.03 / $94.91 / $118.64	Professional	TC	$77.03	$94.91	$118.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.34 / $178.57 / $865.60	Professional		$96.34	$178.57	$865.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.16 / $114.88 / $382.35	Professional	26	$63.16	$114.88	$382.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.98 / $57.56 / $307.58	Professional	TC	$30.98	$57.56	$307.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.96 / $178.48 / $279.58	Professional		$107.96	$178.48	$279.58
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $110.26 / $149.79 / $201.83	Professional		$110.26	$149.79	$201.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.13 / $97.88 / $115.15	Professional	26	$70.13	$97.88	$115.15
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.76 / $62.80 / $86.68	Professional	TC	$40.76	$62.80	$86.68
United Facility/Professional Professional Modifier Low / Median / High Price $86.20 / $167.55 / $210.08	Professional		$86.20	$167.55	$210.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $113.92 / $157.90	Professional	26	$55.22	$113.92	$157.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.98 / $59.24 / $77.92	Professional	TC	$30.98	$59.24	$77.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $208.20 / $216.50 / $254.70	Professional		$208.20	$216.50	$254.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $118.80 / $123.50 / $145.30	Professional	26	$118.80	$123.50	$145.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $89.40 / $93.00 / $109.40	Professional	TC	$89.40	$93.00	$109.40