Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.16 / $98.16 / $98.16	Facility	26	$98.16	$98.16	$98.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.81 / $339.81 / $568.13	Professional		$339.81	$339.81	$568.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.16 / $110.37 / $157.30	Professional	26	$98.16	$110.37	$157.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $324.64 / $324.64 / $401.40	Professional	52	$324.64	$324.64	$401.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.43 / $235.11 / $410.83	Professional	TC	$229.43	$235.11	$410.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $739.44 / $796.24 / $995.30	Professional		$739.44	$796.24	$995.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $216.76 / $229.83 / $287.29	Professional	26	$216.76	$229.83	$287.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $514.72 / $566.41 / $708.01	Professional	TC	$514.72	$566.41	$708.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $348.79 / $641.39 / $2,698.08	Professional		$348.79	$641.39	$2,698.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $125.63 / $209.38 / $770.56	Professional	26	$125.63	$209.38	$770.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $254.87 / $452.59 / $1,927.52	Professional	TC	$254.87	$452.59	$1,927.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $510.81 / $739.44 / $982.41	Professional		$510.81	$739.44	$982.41
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $413.00 / $558.70 / $657.25	Professional		$413.00	$558.70	$657.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $130.18 / $173.62 / $197.95	Professional	26	$130.18	$173.62	$197.95
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $282.83 / $390.43 / $459.30	Professional	TC	$282.83	$390.43	$459.30
United Facility/Professional Professional Modifier Low / Median / High Price $380.50 / $745.99 / $997.72	Professional		$380.50	$745.99	$997.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.16 / $203.06 / $293.69	Professional	26	$115.16	$203.06	$293.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $276.23 / $452.59 / $704.03	Professional	TC	$276.23	$452.59	$704.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $652.00 / $767.10 / $797.80	Professional		$652.00	$767.10	$797.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $196.40 / $231.00 / $240.30	Professional	26	$196.40	$231.00	$240.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $455.60 / $536.00 / $557.50	Professional	TC	$455.60	$536.00	$557.50