Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.13 / $85.13 / $85.13	Facility	26	$85.13	$85.13	$85.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.78 / $217.46 / $529.20	Professional		$133.78	$217.46	$529.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $78.27 / $293.39	Professional	26	$72.04	$78.27	$293.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.55 / $61.75 / $95.34	Professional	TC	$59.55	$61.75	$95.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.19 / $281.25 / $348.08	Professional		$241.19	$281.25	$348.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $139.63 / $161.21 / $201.52	Professional	26	$139.63	$161.21	$201.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.55 / $118.94 / $146.56	Professional	TC	$101.55	$118.94	$146.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $150.07 / $308.89 / $874.03	Professional		$150.07	$308.89	$874.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.12 / $168.60 / $497.06	Professional	26	$89.12	$168.60	$497.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.05 / $137.44 / $376.97	Professional	TC	$69.05	$137.44	$376.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $221.78 / $285.63 / $359.15	Professional		$221.78	$285.63	$359.15
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $159.40 / $218.31 / $256.82	Professional		$159.40	$218.31	$256.82
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $92.30 / $127.58 / $150.08	Professional	26	$92.30	$127.58	$150.08
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $68.31 / $90.73 / $111.49	Professional	TC	$68.31	$90.73	$111.49
United Facility/Professional Professional Modifier Low / Median / High Price $150.07 / $262.56 / $315.14	Professional		$150.07	$262.56	$315.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.02 / $145.72 / $171.44	Professional	26	$81.02	$145.72	$171.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.05 / $117.81 / $172.63	Professional	TC	$69.05	$117.81	$172.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $264.89 / $324.10 / $324.10	Professional		$264.89	$324.10	$324.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.80 / $189.40 / $189.40	Professional	26	$154.80	$189.40	$189.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $110.10 / $134.69 / $134.69	Professional	TC	$110.10	$134.69	$134.69