Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.41 / $131.41 / $131.41	Facility		$131.41	$131.41	$131.41
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 $119.68 / $122.76 / $196.78	Professional		$119.68	$122.76	$196.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $22.73 / $65.86	Professional	26	$20.50	$22.73	$65.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.95 / $102.26 / $205.59	Professional	TC	$96.95	$102.26	$205.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.81 / $246.08 / $306.20	Professional		$198.81	$246.08	$306.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.38 / $46.52 / $57.58	Professional	26	$37.38	$46.52	$57.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.90 / $198.90 / $248.63	Professional	TC	$161.90	$198.90	$248.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $171.14 / $204.47 / $272.73	Facility		$171.14	$204.47	$272.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.15 / $226.28 / $1,013.21	Professional		$132.15	$226.28	$1,013.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.60 / $48.36 / $217.94	Professional	26	$26.60	$48.36	$217.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $105.55 / $191.92 / $889.85	Professional	TC	$105.55	$191.92	$889.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $218.46 / $254.34 / $306.73	Facility		$218.46	$254.34	$306.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.94 / $226.28 / $306.73	Professional		$173.94	$226.28	$306.73
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $143.49 / $197.85 / $225.77	Professional		$143.49	$197.85	$225.77
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.88 / $39.15 / $44.64	Professional	26	$27.88	$39.15	$44.64
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $112.34 / $157.22 / $181.13	Professional	TC	$112.34	$157.22	$181.13
United Facility/Professional Professional Modifier Low / Median / High Price $132.15 / $217.06 / $255.36	Professional		$132.15	$217.06	$255.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.60 / $42.65 / $50.17	Professional	26	$26.60	$42.65	$50.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.55 / $170.17 / $205.19	Professional	TC	$105.55	$170.17	$205.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $215.10 / $253.00 / $263.10	Professional		$215.10	$253.00	$263.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $42.50 / $50.00 / $52.00	Professional	26	$42.50	$50.00	$52.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $172.50 / $203.00 / $211.10	Professional	TC	$172.50	$203.00	$211.10