Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $113.82 / $158.13	Professional		$113.82	$113.82	$158.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $11.77 / $24.17	Professional	26	$11.77	$11.77	$24.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.06 / $102.06 / $133.94	Professional	TC	$102.06	$102.06	$133.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.16 / $274.89 / $380.36	Professional		$162.16	$274.89	$380.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.30 / $43.97 / $54.96	Professional	26	$21.30	$43.97	$54.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.02 / $223.17 / $325.39	Professional	TC	$137.02	$223.17	$325.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.04 / $221.46 / $359.05	Facility		$131.04	$221.46	$359.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.55 / $271.47 / $1,197.25	Professional		$169.55	$271.47	$1,197.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $41.18 / $198.13	Professional	26	$16.26	$41.18	$198.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $149.93 / $236.24 / $1,126.14	Professional	TC	$149.93	$236.24	$1,126.14
Midlands Facility/Professional Facility Modifier Low / Median / High Price $196.03 / $277.83 / $309.36	Facility		$196.03	$277.83	$309.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $176.00 / $253.60 / $331.87	Professional		$176.00	$253.60	$331.87
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $184.38 / $238.94 / $280.75	Professional		$184.38	$238.94	$280.75
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $37.39 / $43.99	Professional	26	$19.60	$37.39	$43.99
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $155.32 / $205.29 / $237.53	Professional	TC	$155.32	$205.29	$237.53
United Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $255.50 / $335.35	Professional		$158.91	$255.50	$335.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $40.46 / $49.50	Professional	26	$16.26	$40.46	$49.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $136.30 / $216.49 / $286.23	Professional	TC	$136.30	$216.49	$286.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $267.50 / $327.20 / $327.20	Professional		$267.50	$327.20	$327.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.90 / $51.30 / $51.30	Professional	26	$41.90	$51.30	$51.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $225.50 / $276.00 / $276.00	Professional	TC	$225.50	$276.00	$276.00