Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.57 / $49.57 / $49.57	Facility	26	$49.57	$49.57	$49.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.31 / $98.85 / $145.56	Professional		$96.31	$98.85	$145.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.66 / $53.95 / $75.97	Professional	TC	$50.66	$53.95	$75.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.79 / $187.50 / $232.05	Professional		$160.79	$187.50	$232.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.00 / $94.45 / $116.90	Professional	TC	$81.00	$94.45	$116.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.48 / $183.22 / $646.83	Professional		$100.48	$183.22	$646.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $51.82 / $103.64 / $354.71	Professional	TC	$51.82	$103.64	$354.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $197.93 / $245.94	Professional		$139.66	$197.93	$245.94
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $103.25 / $146.27 / $172.08	Professional		$103.25	$146.27	$172.08
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $53.31 / $73.69 / $86.68	Professional	26	$53.31	$73.69	$86.68
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $52.19 / $72.59 / $86.13	Professional	TC	$52.19	$72.59	$86.13
United Facility/Professional Professional Modifier Low / Median / High Price $100.48 / $176.88 / $247.34	Professional		$100.48	$176.88	$247.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.82 / $88.09 / $107.82	Professional	TC	$51.82	$88.09	$107.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $177.50 / $217.20 / $217.20	Professional		$177.50	$217.20	$217.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $88.10 / $107.80 / $107.80	Professional	TC	$88.10	$107.80	$107.80