Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $72.44	Facility	26	$45.71	$45.71	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $380.19	Professional		$125.89	$158.49	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $51.29 / $128.82	Professional	26	$39.81	$51.29	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $107.15 / $218.78	Professional	TC	$85.11	$107.15	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $295.12 / $371.54	Professional		$245.47	$295.12	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $91.20 / $114.82	Professional	26	$83.18	$91.20	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $204.17 / $257.04	Professional	TC	$169.82	$204.17	$257.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $257.04 / $1,096.48	Professional		$128.82	$257.04	$1,096.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $81.28 / $446.68	Professional	26	$48.98	$81.28	$446.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $169.82 / $870.96	Professional	TC	$93.33	$169.82	$870.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $275.42	Professional		$269.15	$269.15	$275.42
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $102.33	Professional	26	$89.13	$89.13	$102.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $177.83 / $177.83	Professional	TC	$169.82	$177.83	$177.83
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $275.42	Professional		$162.18	$223.87	$275.42
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $91.20	Professional	26	$54.95	$72.44	$91.20
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $158.49 / $186.21	Professional	TC	$109.65	$158.49	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $245.47 / $302.00	Professional		$144.54	$245.47	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $77.62 / $97.72	Professional	26	$46.77	$77.62	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $169.82 / $204.17	Professional	TC	$100.00	$169.82	$204.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $331.13	Professional		$269.15	$316.23	$331.13
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $100.00 / $104.71	Professional	26	$85.11	$100.00	$104.71
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $218.78 / $223.87	Professional	TC	$186.21	$218.78	$223.87