Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.94 / $40.94 / $40.94	Facility	26	$40.94	$40.94	$40.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.63 / $219.03 / $334.50	Professional		$146.63	$219.03	$334.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.25 / $56.89 / $202.92	Professional	26	$36.25	$56.89	$202.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.65 / $162.12 / $246.17	Professional	TC	$106.65	$162.12	$246.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.74 / $333.60 / $417.00	Professional		$270.74	$333.60	$417.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.30 / $77.54 / $95.96	Professional	26	$62.30	$77.54	$95.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.44 / $256.83 / $321.02	Professional	TC	$208.44	$256.83	$321.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.35 / $298.55 / $1,354.08	Professional		$181.35	$298.55	$1,354.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.80 / $79.66 / $335.64	Professional	26	$47.80	$79.66	$335.64
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $137.53 / $250.06 / $1,018.44	Professional	TC	$137.53	$250.06	$1,018.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $221.39 / $286.61 / $402.64	Professional		$221.39	$286.61	$402.64
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $198.23 / $268.05 / $305.98	Professional		$198.23	$268.05	$305.98
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $65.20 / $72.45	Professional	26	$48.86	$65.20	$72.45
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $143.03 / $201.91 / $233.53	Professional	TC	$143.03	$201.91	$233.53
United Facility/Professional Professional Modifier Low / Median / High Price $181.35 / $296.06 / $348.31	Professional		$181.35	$296.06	$348.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $70.76 / $83.25	Professional	26	$43.82	$70.76	$83.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.29 / $225.30 / $265.06	Professional	TC	$133.29	$225.30	$265.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $291.50 / $342.90 / $356.60	Professional		$291.50	$342.90	$356.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.00 / $81.20 / $84.40	Professional	26	$69.00	$81.20	$84.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $222.50 / $261.70 / $272.20	Professional	TC	$222.50	$261.70	$272.20