Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.09 / $48.09 / $48.09	Facility	26	$48.09	$48.09	$48.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $87.27 / $142.41	Professional		$79.34	$87.27	$142.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.99 / $43.94 / $67.93	Professional	26	$41.99	$43.94	$67.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.35 / $41.17 / $74.48	Professional	TC	$37.35	$41.17	$74.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.61 / $181.45 / $226.82	Professional		$155.61	$181.45	$226.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.20 / $90.93 / $112.54	Professional	26	$77.20	$90.93	$112.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.20 / $91.42 / $114.28	Professional	TC	$74.20	$91.42	$114.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.41 / $160.63 / $567.30	Professional		$85.41	$160.63	$567.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.43 / $90.86 / $318.67	Professional	26	$45.43	$90.86	$318.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $39.97 / $79.95 / $318.67	Professional	TC	$39.97	$79.95	$318.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.82 / $170.48 / $211.83	Professional		$120.82	$170.48	$211.83
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $96.89 / $141.28 / $167.55	Professional		$96.89	$141.28	$167.55
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.72 / $71.48 / $84.10	Professional	26	$51.72	$71.48	$84.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.05 / $67.50 / $83.45	Professional	TC	$44.05	$67.50	$83.45
United Facility/Professional Professional Modifier Low / Median / High Price $85.41 / $154.91 / $182.26	Professional		$85.41	$154.91	$182.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.43 / $81.88 / $96.33	Professional	26	$45.43	$81.88	$96.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.97 / $73.04 / $85.93	Professional	TC	$39.97	$73.04	$85.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $172.80 / $211.40 / $211.40	Professional		$172.80	$211.40	$211.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $86.70 / $106.10 / $106.10	Professional	26	$86.70	$106.10	$106.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $86.10 / $105.30 / $105.30	Professional	TC	$86.10	$105.30	$105.30