Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.86 / $36.86 / $36.86	Facility	26	$36.86	$36.86	$36.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $97.18 / $212.08	Professional		$64.31	$97.18	$212.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.26 / $33.99 / $52.98	Professional	26	$31.26	$33.99	$52.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $36.33 / $117.35	Professional	TC	$33.03	$36.33	$117.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.88 / $214.26 / $267.82	Professional		$173.88	$214.26	$267.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.85 / $69.79 / $87.24	Professional	26	$59.85	$69.79	$87.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.24 / $144.47 / $180.58	Professional	TC	$117.24	$144.47	$180.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $171.16 / $687.40	Professional		$91.20	$171.16	$687.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.52 / $69.04 / $224.56	Professional	26	$34.52	$69.04	$224.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $52.66 / $108.09 / $472.45	Professional	TC	$52.66	$108.09	$472.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.55 / $161.63 / $203.11	Professional		$97.55	$161.63	$203.11
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $95.12 / $138.04 / $196.66	Professional		$95.12	$138.04	$196.66
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $40.18 / $55.54 / $65.34	Professional	26	$40.18	$55.54	$65.34
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $54.71 / $86.26 / $131.32	Professional	TC	$54.71	$86.26	$131.32
United Facility/Professional Professional Modifier Low / Median / High Price $90.63 / $169.74 / $205.98	Professional		$90.63	$169.74	$205.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $62.55 / $73.58	Professional	26	$33.94	$62.55	$73.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.66 / $108.09 / $151.41	Professional	TC	$52.66	$108.09	$151.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $202.80 / $248.20 / $248.20	Professional		$202.80	$248.20	$248.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $67.40 / $82.50 / $82.50	Professional	26	$67.40	$82.50	$82.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $135.50 / $165.70 / $165.70	Professional	TC	$135.50	$165.70	$165.70