Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.22 / $195.22 / $2,290.00	Facility		$195.22	$195.22	$2,290.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.63 / $37.63 / $37.63	Facility	26	$37.63	$37.63	$37.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $168.38 / $352.16	Professional		$152.68	$168.38	$352.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.69 / $43.81 / $90.26	Professional	26	$36.69	$43.81	$90.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $108.87 / $119.75 / $261.88	Professional	TC	$108.87	$119.75	$261.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $356.12 / $391.89 / $489.86	Professional		$356.12	$391.89	$489.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.00 / $88.04 / $110.05	Professional	26	$80.00	$88.04	$110.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $276.12 / $303.85 / $379.81	Professional	TC	$276.12	$303.85	$379.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $185.30 / $284.56 / $511.07	Facility		$185.30	$284.56	$511.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $135.13 / $296.19 / $1,531.99	Professional		$135.13	$296.19	$1,531.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.13 / $80.22 / $907.84	Professional	26	$48.13	$80.22	$907.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $87.00 / $224.12 / $1,117.24	Professional	TC	$87.00	$224.12	$1,117.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $169.97 / $463.36 / $563.82	Facility		$169.97	$463.36	$563.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $220.20 / $362.45 / $528.05	Professional		$220.20	$362.45	$528.05
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $180.75 / $273.85 / $323.19	Professional		$180.75	$273.85	$323.19
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $50.17 / $66.14 / $75.69	Professional	26	$50.17	$66.14	$75.69
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $115.40 / $209.51 / $257.76	Professional	TC	$115.40	$209.51	$257.76
United Facility/Professional Facility Modifier Low / Median / High Price $821.00 / $821.00 / $821.00	Facility		$821.00	$821.00	$821.00
United Facility/Professional Professional Modifier Low / Median / High Price $146.88 / $296.19 / $460.74	Professional		$146.88	$296.19	$460.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.94 / $77.90 / $112.11	Professional	26	$48.94	$77.90	$112.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $145.00 / $224.68 / $348.63	Professional	TC	$145.00	$224.68	$348.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $319.60 / $376.00 / $391.00	Professional		$319.60	$376.00	$391.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $75.09 / $88.30 / $91.90	Professional	26	$75.09	$88.30	$91.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $244.50 / $287.70 / $299.20	Professional	TC	$244.50	$287.70	$299.20