Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.71 / $54.71 / $54.71	Facility	26	$54.71	$54.71	$54.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.32 / $259.94 / $370.52	Professional		$138.32	$259.94	$370.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.56 / $51.50 / $68.14	Professional	26	$47.56	$51.50	$68.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.77 / $208.43 / $302.37	Professional	TC	$90.77	$208.43	$302.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.64 / $352.94 / $441.18	Professional		$288.64	$352.94	$441.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.60 / $121.78 / $152.22	Professional	26	$99.60	$121.78	$152.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.04 / $231.16 / $288.95	Professional	TC	$189.04	$231.16	$288.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $195.42 / $303.92 / $1,547.04	Professional		$195.42	$303.92	$1,547.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.78 / $104.71 / $363.24	Professional	26	$67.78	$104.71	$363.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $127.64 / $199.21 / $1,263.33	Professional	TC	$127.64	$199.21	$1,263.33
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $177.50 / $177.50 / $177.50	Facility	26	$177.50	$177.50	$177.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $312.44 / $364.95 / $489.00	Professional		$312.44	$364.95	$489.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $194.80 / $263.41 / $314.89	Professional		$194.80	$263.41	$314.89
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $90.22 / $102.86	Professional	26	$69.08	$90.22	$102.86
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $125.71 / $169.68 / $217.58	Professional	TC	$125.71	$169.68	$217.58
United Facility/Professional Professional Modifier Low / Median / High Price $182.15 / $295.70 / $336.42	Professional		$182.15	$295.70	$336.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.52 / $104.71 / $121.13	Professional	26	$63.52	$104.71	$121.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.01 / $193.82 / $223.38	Professional	TC	$117.01	$193.82	$223.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $290.10 / $341.30 / $341.30	Professional		$290.10	$341.30	$341.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $102.00 / $120.00 / $120.00	Professional	26	$102.00	$120.00	$120.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $188.00 / $221.20 / $221.20	Professional	TC	$188.00	$221.20	$221.20