Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $26.72 / $26.72	Facility	26	$26.72	$26.72	$26.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.26 / $133.69 / $146.22	Professional		$95.26	$133.69	$146.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.39 / $29.26 / $42.92	Professional	26	$24.39	$29.26	$42.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.98 / $100.25 / $119.51	Professional	TC	$65.98	$100.25	$119.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.20 / $341.27 / $426.59	Professional		$257.20	$341.27	$426.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.60 / $72.58 / $90.73	Professional	26	$54.60	$72.58	$90.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $202.51 / $268.69 / $335.86	Professional	TC	$202.51	$268.69	$335.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $166.34 / $295.29 / $1,341.64	Professional		$166.34	$295.29	$1,341.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $50.94 / $375.24	Professional	26	$28.02	$50.94	$375.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $138.32 / $251.50 / $1,090.58	Professional	TC	$138.32	$251.50	$1,090.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.36 / $253.99 / $326.80	Professional		$199.36	$253.99	$326.80
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $181.06 / $248.94 / $312.45	Professional		$181.06	$248.94	$312.45
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.89 / $42.50 / $68.56	Professional	26	$30.89	$42.50	$68.56
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $150.16 / $206.47 / $247.76	Professional	TC	$150.16	$206.47	$247.76
United Facility/Professional Professional Modifier Low / Median / High Price $170.61 / $292.83 / $344.51	Professional		$170.61	$292.83	$344.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $46.67 / $54.46	Professional	26	$28.02	$46.67	$54.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.66 / $248.62 / $290.05	Professional	TC	$148.66	$248.62	$290.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $297.60 / $350.20 / $364.20	Professional		$297.60	$350.20	$364.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $65.30 / $76.90 / $79.90	Professional	26	$65.30	$76.90	$79.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $232.30 / $273.30 / $284.30	Professional	TC	$232.30	$273.30	$284.30