Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $1,778.28	Professional		$295.12	$407.38	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $223.87	Professional	26	$70.79	$125.89	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $295.12 / $562.34	Professional	TC	$190.55	$295.12	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $645.65 / $794.33	Professional		$512.86	$645.65	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $162.18 / $199.53	Professional	26	$128.82	$162.18	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $478.63 / $602.56	Professional	TC	$380.19	$478.63	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $549.54 / $912.01	Professional		$275.42	$549.54	$912.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $549.54	Professional	26	$74.13	$125.89	$549.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $426.58 / $2,511.89	Professional	TC	$251.19	$426.58	$2,511.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $562.34 / $676.08	Professional		$524.81	$562.34	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $147.91 / $169.82	Professional	26	$141.25	$147.91	$169.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $416.87 / $501.19	Professional	TC	$389.05	$416.87	$501.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	26	$151.36	$151.36	$151.36
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $467.74 / $467.74	Professional	TC	$467.74	$467.74	$467.74
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $512.86 / $660.69	Professional		$346.74	$512.86	$660.69
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $114.82 / $134.90	Professional	26	$85.11	$114.82	$134.90
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $380.19 / $562.34	Professional	TC	$263.03	$380.19	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $549.54 / $741.31	Professional		$323.59	$549.54	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $177.83	Professional	26	$74.13	$125.89	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $436.52 / $562.34	Professional	TC	$245.47	$436.52	$562.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $691.83 / $691.83	Professional		$588.84	$691.83	$691.83
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $181.97 / $181.97	Professional	26	$154.88	$181.97	$181.97
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $512.86 / $512.86	Professional	TC	$436.52	$512.86	$512.86