Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.93 / $46.93 / $46.93	Facility	26	$46.93	$46.93	$46.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.16 / $151.71 / $278.75	Professional		$139.16	$151.71	$278.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.91 / $45.11 / $69.34	Professional	26	$42.91	$45.11	$69.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.26 / $106.59 / $161.80	Professional	TC	$96.26	$106.59	$161.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.22 / $286.14 / $357.67	Professional		$232.22	$286.14	$357.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.93 / $89.52 / $110.79	Professional	26	$71.93	$89.52	$110.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.29 / $197.51 / $246.88	Professional	TC	$160.29	$197.51	$246.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $261.68 / $1,086.26	Professional		$143.91	$261.68	$1,086.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.82 / $90.58 / $449.09	Professional	26	$49.82	$90.58	$449.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.10 / $175.23 / $867.64	Professional	TC	$94.10	$175.23	$867.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $191.40 / $268.24 / $357.00	Professional		$191.40	$268.24	$357.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $158.05 / $222.71 / $261.99	Professional		$158.05	$222.71	$261.99
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.43 / $72.63 / $82.80	Professional	26	$54.43	$72.63	$82.80
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $102.92 / $152.32 / $179.19	Professional	TC	$102.92	$152.32	$179.19
United Facility/Professional Professional Modifier Low / Median / High Price $149.77 / $255.01 / $300.01	Professional		$149.77	$255.01	$300.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $81.23 / $95.57	Professional	26	$46.51	$81.23	$95.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.66 / $171.10 / $204.44	Professional	TC	$102.66	$171.10	$204.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $270.20 / $317.89 / $330.60	Professional		$270.20	$317.89	$330.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $85.40 / $100.50 / $104.50	Professional	26	$85.40	$100.50	$104.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $184.80 / $217.40 / $226.10	Professional	TC	$184.80	$217.40	$226.10