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 $124.43 / $148.08 / $335.80	Professional		$124.43	$148.08	$335.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.92 / $47.21 / $68.28	Professional	26	$42.92	$47.21	$68.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.36 / $105.15 / $128.37	Professional	TC	$80.36	$105.15	$128.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.07 / $250.94 / $310.57	Professional		$213.07	$250.94	$310.57
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 $137.22 / $160.01 / $198.03	Professional	TC	$137.22	$160.01	$198.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.88 / $245.29 / $944.58	Professional		$141.88	$245.29	$944.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.93 / $91.86 / $386.24	Professional	26	$45.93	$91.86	$386.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $95.96 / $176.11 / $782.04	Professional	TC	$95.96	$176.11	$782.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $207.05 / $262.74 / $398.87	Professional		$207.05	$262.74	$398.87
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $137.02 / $200.29 / $313.31	Professional		$137.02	$200.29	$313.31
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $52.12 / $72.04 / $84.74	Professional	26	$52.12	$72.04	$84.74
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $86.17 / $125.96 / $237.88	Professional	TC	$86.17	$125.96	$237.88
United Facility/Professional Professional Modifier Low / Median / High Price $156.08 / $241.21 / $297.97	Professional		$156.08	$241.21	$297.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.52 / $87.34 / $114.83	Professional	26	$50.52	$87.34	$114.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.96 / $150.94 / $199.66	Professional	TC	$95.96	$150.94	$199.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $235.50 / $288.20 / $288.20	Professional		$235.50	$288.20	$288.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $87.40 / $106.90 / $106.90	Professional	26	$87.40	$106.90	$106.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $148.10 / $181.20 / $181.20	Professional	TC	$148.10	$181.20	$181.20