Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.47 / $158.26 / $158.26	Facility		$143.47	$158.26	$158.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.44 / $22.44 / $22.44	Facility	26	$22.44	$22.44	$22.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.15 / $178.25 / $302.06	Professional		$132.15	$178.25	$302.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $21.17 / $31.95	Professional	26	$19.60	$21.17	$31.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $66.08 / $66.08 / $170.52	Professional	52	$66.08	$66.08	$170.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.48 / $157.09 / $238.50	Professional	TC	$111.48	$157.09	$238.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.46 / $273.94 / $341.10	Professional		$221.46	$273.94	$341.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $42.29 / $52.34	Professional	26	$33.97	$42.29	$52.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $187.48 / $231.00 / $288.76	Professional	TC	$187.48	$231.00	$288.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $189.83 / $235.25 / $313.05	Facility		$189.83	$235.25	$313.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $152.30 / $251.22 / $1,173.20	Professional		$152.30	$251.22	$1,173.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $43.76 / $310.41	Professional	26	$24.07	$43.76	$310.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $128.22 / $233.14 / $1,048.79	Professional	TC	$128.22	$233.14	$1,048.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $240.65 / $299.06 / $332.26	Facility		$240.65	$299.06	$332.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.00 / $251.22 / $332.26	Professional		$186.00	$251.22	$332.26
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $166.66 / $224.22 / $251.64	Professional		$166.66	$224.22	$251.64
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.99 / $35.75 / $40.75	Professional	26	$26.99	$35.75	$40.75
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $138.88 / $188.19 / $213.29	Professional	TC	$138.88	$188.19	$213.29
United Facility/Professional Professional Modifier Low / Median / High Price $152.30 / $240.08 / $286.08	Professional		$152.30	$240.08	$286.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $38.88 / $47.02	Professional	26	$24.07	$38.88	$47.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.22 / $201.20 / $234.74	Professional	TC	$128.22	$201.20	$234.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $239.70 / $282.00 / $293.30	Professional		$239.70	$282.00	$293.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.79 / $45.70 / $47.50	Professional	26	$38.79	$45.70	$47.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $200.90 / $236.40 / $245.80	Professional	TC	$200.90	$236.40	$245.80