Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.44 / $24.44 / $24.44	Facility	26	$24.44	$24.44	$24.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.76 / $127.80 / $206.87	Professional		$116.76	$127.80	$206.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $22.18 / $127.80	Professional	26	$14.49	$22.18	$127.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.26 / $112.49 / $161.49	Professional	TC	$102.26	$112.49	$161.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.00 / $260.10 / $321.91	Professional		$209.00	$260.10	$321.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $45.82 / $56.70	Professional	26	$36.82	$45.82	$56.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.19 / $214.05 / $265.20	Professional	TC	$172.19	$214.05	$265.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.26 / $242.01 / $1,021.59	Professional		$142.26	$242.01	$1,021.59
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.44 / $48.08 / $203.09	Professional	26	$26.44	$48.08	$203.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $115.82 / $210.58 / $934.78	Professional	TC	$115.82	$210.58	$934.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $175.00 / $242.01 / $316.73	Professional		$175.00	$242.01	$316.73
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $145.78 / $207.67 / $236.77	Professional		$145.78	$207.67	$236.77
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.46 / $38.58 / $43.99	Professional	26	$24.46	$38.58	$43.99
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $118.67 / $169.09 / $192.78	Professional	TC	$118.67	$169.09	$192.78
United Facility/Professional Professional Modifier Low / Median / High Price $155.19 / $247.00 / $281.61	Professional		$155.19	$247.00	$281.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.44 / $43.42 / $50.65	Professional	26	$26.44	$43.42	$50.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.82 / $188.59 / $221.87	Professional	TC	$115.82	$188.59	$221.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $225.50 / $265.39 / $276.00	Professional		$225.50	$265.39	$276.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.90 / $49.30 / $51.30	Professional	26	$41.90	$49.30	$51.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $183.60 / $216.10 / $224.70	Professional	TC	$183.60	$216.10	$224.70