Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $64.57 / $64.57	Facility	26	$61.66	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $338.84	Professional		$107.15	$162.18	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $147.91	Professional	26	$53.70	$64.57	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $64.57 / $181.97	Professional	TC	$52.48	$64.57	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $251.19 / $316.23	Professional		$229.09	$251.19	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $125.89 / $154.88	Professional	26	$114.82	$125.89	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $125.89 / $158.49	Professional	TC	$117.49	$125.89	$158.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $223.87 / $1,071.52	Professional		$112.20	$223.87	$1,071.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $371.54	Professional	26	$64.57	$112.20	$371.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $120.23 / $707.95	Professional	TC	$66.07	$120.23	$707.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $275.42	Professional		$239.88	$239.88	$275.42
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $138.04	Professional	26	$123.03	$123.03	$138.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $117.49 / $138.04	Professional	TC	$117.49	$117.49	$138.04
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $199.53 / $245.47	Professional		$141.25	$199.53	$245.47
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $97.72 / $114.82	Professional	26	$72.44	$97.72	$114.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $97.72 / $154.88	Professional	TC	$70.79	$97.72	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $218.78 / $331.13	Professional		$128.82	$218.78	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $109.65 / $131.83	Professional	26	$64.57	$109.65	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $109.65 / $165.96	Professional	TC	$64.57	$109.65	$165.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $251.19 / $263.03	Professional		$213.80	$251.19	$263.03
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $128.82 / $131.83	Professional	26	$109.65	$128.82	$131.83
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $125.89 / $131.83	Professional	TC	$107.15	$125.89	$131.83