Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.81 / $24.81 / $24.81	Facility	26	$24.81	$24.81	$24.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.54 / $180.90 / $271.70	Professional		$126.54	$180.90	$271.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $22.73 / $35.07	Professional	26	$18.76	$22.73	$35.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.81 / $162.12 / $237.21	Professional	TC	$103.81	$162.12	$237.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.13 / $261.51 / $323.64	Professional		$210.13	$261.51	$323.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.38 / $46.32 / $57.58	Professional	26	$37.38	$46.32	$57.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.75 / $214.05 / $266.07	Professional	TC	$172.75	$214.05	$266.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.19 / $241.83 / $1,035.17	Professional		$142.19	$241.83	$1,035.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.76 / $48.64 / $303.79	Professional	26	$26.76	$48.64	$303.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $115.43 / $209.88 / $922.24	Professional	TC	$115.43	$209.88	$922.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.00 / $241.83 / $315.86	Professional		$173.00	$241.83	$315.86
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $146.96 / $208.80 / $238.06	Professional		$146.96	$208.80	$238.06
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.87 / $39.15 / $44.64	Professional	26	$26.87	$39.15	$44.64
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $119.45 / $169.65 / $193.42	Professional	TC	$119.45	$169.65	$193.42
United Facility/Professional Professional Modifier Low / Median / High Price $155.11 / $249.00 / $281.35	Professional		$155.11	$249.00	$281.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.76 / $43.13 / $50.74	Professional	26	$26.76	$43.13	$50.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.43 / $187.30 / $283.73	Professional	TC	$115.43	$187.30	$283.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $226.80 / $266.80 / $277.50	Professional		$226.80	$266.80	$277.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $42.50 / $50.00 / $52.00	Professional	26	$42.50	$50.00	$52.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $184.30 / $216.80 / $225.40	Professional	TC	$184.30	$216.80	$225.40