Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.88 / $48.88 / $48.88	Facility	26	$48.88	$48.88	$48.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $235.80 / $539.34	Professional		$84.00	$235.80	$539.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $69.97 / $170.10	Professional	26	$43.82	$69.97	$170.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.17 / $52.60 / $85.15	Professional	TC	$40.17	$52.60	$85.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.07 / $197.51 / $246.88	Professional		$171.07	$197.51	$246.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.79 / $92.12 / $115.15	Professional	26	$79.79	$92.12	$115.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.20 / $105.38 / $131.72	Professional	TC	$88.20	$105.38	$131.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $94.29 / $190.85 / $641.76	Professional		$94.29	$190.85	$641.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $55.31 / $83.86 / $283.72	Professional	26	$55.31	$83.86	$283.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.37 / $93.55 / $358.05	Professional	TC	$49.37	$93.55	$358.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $135.27 / $182.09 / $264.97	Professional		$135.27	$182.09	$264.97
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $110.27 / $149.11 / $181.13	Professional		$110.27	$149.11	$181.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.87 / $73.14 / $86.04	Professional	26	$51.87	$73.14	$86.04
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $54.49 / $73.69 / $95.09	Professional	TC	$54.49	$73.69	$95.09
United Facility/Professional Professional Modifier Low / Median / High Price $94.29 / $177.41 / $229.30	Professional		$94.29	$177.41	$229.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.15 / $83.86 / $97.84	Professional	26	$51.15	$83.86	$97.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.37 / $90.44 / $112.22	Professional	TC	$49.37	$90.44	$112.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.80 / $228.60 / $228.60	Professional		$186.80	$228.60	$228.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $88.70 / $108.60 / $108.60	Professional	26	$88.70	$108.60	$108.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $98.10 / $120.00 / $120.00	Professional	TC	$98.10	$120.00	$120.00