Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.84 / $26.84 / $26.84	Facility	26	$26.84	$26.84	$26.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.77 / $108.65 / $201.28	Professional		$98.77	$108.65	$201.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $36.17 / $131.40	Professional	26	$23.50	$36.17	$131.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.79 / $125.64 / $591.85	Professional	TC	$82.79	$125.64	$591.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.09 / $207.94 / $257.35	Professional		$167.09	$207.94	$257.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.78 / $50.75 / $62.81	Professional	26	$40.78	$50.75	$62.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.31 / $156.94 / $194.54	Professional	TC	$126.31	$156.94	$194.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.04 / $210.02 / $698.76	Professional		$126.04	$210.02	$698.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.34 / $51.52 / $279.51	Professional	26	$28.34	$51.52	$279.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $107.76 / $155.65 / $479.00	Professional	TC	$107.76	$155.65	$479.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.00 / $188.00 / $268.06	Professional		$151.00	$188.00	$268.06
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $125.69 / $165.68 / $206.85	Professional		$125.69	$165.68	$206.85
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.23 / $41.42 / $47.22	Professional	26	$31.23	$41.42	$47.22
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.62 / $124.26 / $161.30	Professional	TC	$87.62	$124.26	$161.30
United Facility/Professional Professional Modifier Low / Median / High Price $108.38 / $178.52 / $252.08	Professional		$108.38	$178.52	$252.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.34 / $46.22 / $54.37	Professional	26	$28.34	$46.22	$54.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.50 / $133.41 / $200.56	Professional	TC	$96.50	$133.41	$200.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $194.80 / $229.20 / $238.40	Professional		$194.80	$229.20	$238.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $48.70 / $57.30 / $59.60	Professional	26	$48.70	$57.30	$59.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $146.10 / $171.90 / $178.80	Professional	TC	$146.10	$171.90	$178.80