Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.06 / $25.06 / $25.06	Facility	26	$25.06	$25.06	$25.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.66 / $223.06 / $373.49	Professional		$162.66	$223.06	$373.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $25.06 / $63.90	Professional	26	$21.63	$25.06	$63.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.94 / $199.63 / $338.54	Professional	TC	$139.94	$199.63	$338.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.44 / $338.99 / $419.61	Professional		$272.44	$338.99	$419.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.95 / $47.23 / $58.45	Professional	26	$37.95	$47.23	$58.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.49 / $289.83 / $361.16	Professional	TC	$234.49	$289.83	$361.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.19 / $311.22 / $1,431.47	Professional		$190.19	$311.22	$1,431.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.84 / $48.80 / $293.89	Professional	26	$26.84	$48.80	$293.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $163.35 / $296.14 / $1,288.22	Professional	TC	$163.35	$296.14	$1,288.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $220.00 / $310.72 / $412.10	Professional		$220.00	$310.72	$412.10
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $188.61 / $270.64 / $308.57	Professional		$188.61	$270.64	$308.57
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.90 / $39.72 / $45.28	Professional	26	$29.90	$39.72	$45.28
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $161.10 / $230.93 / $263.29	Professional	TC	$161.10	$230.93	$263.29
United Facility/Professional Professional Modifier Low / Median / High Price $190.19 / $297.25 / $363.09	Professional		$190.19	$297.25	$363.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.84 / $43.42 / $50.65	Professional	26	$26.84	$43.42	$50.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.35 / $253.83 / $297.00	Professional	TC	$163.35	$253.83	$297.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $294.00 / $345.80 / $359.70	Professional		$294.00	$345.80	$359.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $43.10 / $50.80 / $52.80	Professional	26	$43.10	$50.80	$52.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $250.80 / $295.10 / $306.89	Professional	TC	$250.80	$295.10	$306.89