Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.74 / $47.74 / $47.74	Facility	26	$47.74	$47.74	$47.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.97 / $185.43 / $248.55	Professional		$95.97	$185.43	$248.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.32 / $67.14 / $148.63	Professional	26	$42.32	$67.14	$148.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.53 / $51.40 / $108.76	Professional	52	$46.53	$51.40	$108.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.38 / $126.14 / $157.30	Professional	TC	$52.38	$126.14	$157.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.06 / $238.20 / $249.33	Professional		$199.06	$238.20	$249.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.86 / $92.40 / $110.05	Professional	26	$87.86	$92.40	$110.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.20 / $139.00 / $141.22	Professional	TC	$111.20	$139.00	$141.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.83 / $248.18 / $3,000.00	Professional		$154.83	$248.18	$3,000.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.36 / $95.57 / $870.13	Professional	26	$61.36	$95.57	$870.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $101.74 / $152.61 / $870.13	Professional	TC	$101.74	$152.61	$870.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $229.54 / $252.42 / $338.30	Professional		$229.54	$252.42	$338.30
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $111.79 / $177.00 / $279.61	Professional		$111.79	$177.00	$279.61
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.96 / $74.94 / $101.46	Professional	26	$51.96	$74.94	$101.46
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $60.51 / $102.86 / $178.15	Professional	TC	$60.51	$102.86	$178.15
United Facility/Professional Professional Modifier Low / Median / High Price $141.30 / $215.28 / $354.98	Professional		$141.30	$215.28	$354.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.05 / $81.23 / $128.86	Professional	26	$60.05	$81.23	$128.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.89 / $142.09 / $227.29	Professional	TC	$76.89	$142.09	$227.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $192.20 / $235.10 / $235.10	Professional		$192.20	$235.10	$235.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $86.10 / $105.30 / $105.30	Professional	26	$86.10	$105.30	$105.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $106.10 / $129.80 / $129.80	Professional	TC	$106.10	$129.80	$129.80