Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.86 / $99.86 / $99.86	Facility	26	$99.86	$99.86	$99.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.32 / $368.09 / $880.64	Professional		$324.32	$368.09	$880.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.51 / $99.86 / $304.14	Professional	26	$89.51	$99.86	$304.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.81 / $268.23 / $576.47	Professional	TC	$234.81	$268.23	$576.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $736.37 / $797.80 / $997.25	Professional		$736.37	$797.80	$997.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $220.43 / $233.73 / $292.16	Professional	26	$220.43	$233.73	$292.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $512.59 / $564.07 / $705.09	Professional	TC	$512.59	$564.07	$705.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $344.60 / $632.38 / $2,710.64	Professional		$344.60	$632.38	$2,710.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $128.38 / $213.98 / $785.60	Professional	26	$128.38	$213.98	$785.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $247.53 / $440.91 / $1,925.04	Professional	TC	$247.53	$440.91	$1,925.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $510.81 / $743.09 / $984.81	Professional		$510.81	$743.09	$984.81
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $406.09 / $561.45 / $660.48	Professional		$406.09	$561.45	$660.48
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $132.34 / $177.60 / $202.48	Professional	26	$132.34	$177.60	$202.48
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $273.76 / $389.33 / $458.01	Professional	TC	$273.76	$389.33	$458.01
United Facility/Professional Professional Modifier Low / Median / High Price $375.92 / $632.38 / $983.70	Professional		$375.92	$632.38	$983.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $135.44 / $191.47 / $297.83	Professional	26	$135.44	$191.47	$297.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $319.02 / $498.41 / $685.86	Professional	TC	$319.02	$498.41	$685.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $655.20 / $770.90 / $801.70	Professional		$655.20	$770.90	$801.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $200.90 / $236.30 / $245.80	Professional	26	$200.90	$236.30	$245.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $454.40 / $534.50 / $555.90	Professional	TC	$454.40	$534.50	$555.90