Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.49 / $61.49 / $61.49	Facility	26	$61.49	$61.49	$61.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.83 / $314.94 / $449.34	Professional		$161.83	$314.94	$449.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.49 / $66.47 / $282.60	Professional	26	$53.49	$66.47	$282.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $108.34 / $256.70 / $372.43	Professional	TC	$108.34	$256.70	$372.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $337.49 / $412.67 / $515.84	Professional		$337.49	$412.67	$515.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.65 / $136.52 / $170.65	Professional	26	$111.65	$136.52	$170.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.84 / $276.14 / $345.19	Professional	TC	$225.84	$276.14	$345.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $231.08 / $356.25 / $1,897.57	Professional		$231.08	$356.25	$1,897.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $76.31 / $117.64 / $435.88	Professional	26	$76.31	$117.64	$435.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $154.77 / $238.61 / $1,600.00	Professional	TC	$154.77	$238.61	$1,600.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $201.64 / $201.64 / $201.64	Facility	26	$201.64	$201.64	$201.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $369.42 / $426.97 / $598.00	Professional		$369.42	$426.97	$598.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $230.40 / $311.57 / $382.93	Professional		$230.40	$311.57	$382.93
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.66 / $101.56 / $115.80	Professional	26	$77.66	$101.56	$115.80
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $206.55 / $259.17	Professional	TC	$152.75	$206.55	$259.17
United Facility/Professional Professional Modifier Low / Median / High Price $213.31 / $346.63 / $393.95	Professional		$213.31	$346.63	$393.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.50 / $117.64 / $133.97	Professional	26	$71.50	$117.64	$133.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.81 / $232.16 / $270.86	Professional	TC	$141.81	$232.16	$270.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $338.80 / $398.60 / $398.60	Professional		$338.80	$398.60	$398.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.90 / $135.10 / $135.10	Professional	26	$114.90	$135.10	$135.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $224.00 / $263.50 / $263.50	Professional	TC	$224.00	$263.50	$263.50