Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $41.69	Facility	26	$25.70	$25.70	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $363.08	Professional		$87.10	$123.03	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.88 / $97.72	Professional	26	$23.44	$33.88	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $109.65 / $575.44	Professional	TC	$67.61	$109.65	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $263.03	Professional		$186.21	$213.80	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $51.29 / $64.57	Professional	26	$46.77	$51.29	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $158.49 / $199.53	Professional	TC	$134.90	$158.49	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $199.53 / $691.83	Professional		$107.15	$199.53	$691.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $46.77 / $281.84	Professional	26	$28.18	$46.77	$281.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $154.88 / $478.63	Professional	TC	$91.20	$154.88	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $229.09	Professional		$186.21	$186.21	$229.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $51.29 / $57.54	Professional	26	$51.29	$51.29	$57.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $134.90 / $169.82	Professional	TC	$134.90	$134.90	$169.82
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $213.80	Professional		$120.23	$165.96	$213.80
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $53.70	Professional	26	$30.90	$41.69	$53.70
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $123.03 / $162.18	Professional	TC	$89.13	$123.03	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $186.21 / $275.42	Professional		$107.15	$186.21	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $45.71 / $54.95	Professional	26	$26.92	$45.71	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $144.54 / $213.80	Professional	TC	$85.11	$144.54	$213.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $229.09 / $239.88	Professional		$194.98	$229.09	$239.88
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $57.54 / $60.26	Professional	26	$48.98	$57.54	$60.26
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $173.78 / $177.83	Professional	TC	$144.54	$173.78	$177.83