Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $61.66 / $61.66	Facility	26	$43.65	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $245.47 / $602.56	Professional		$162.18	$245.47	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $97.72 / $208.93	Professional	26	$56.23	$97.72	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $158.49 / $316.23	Professional	TC	$107.15	$158.49	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $426.58 / $524.81	Professional		$338.84	$426.58	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $141.25 / $173.78	Professional	26	$112.20	$141.25	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $281.84 / $354.81	Professional	TC	$223.87	$281.84	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $323.59 / $549.54	Professional		$169.82	$323.59	$549.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $109.65 / $436.52	Professional	26	$63.10	$109.65	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $218.78 / $1,584.89	Professional	TC	$128.82	$218.78	$1,584.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $371.54 / $426.58	Professional		$346.74	$371.54	$426.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $128.82 / $147.91	Professional	26	$120.23	$128.82	$147.91
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $251.19 / $281.84	Professional	TC	$229.09	$251.19	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Professional	26	$131.83	$131.83	$131.83
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $263.03 / $263.03	Professional	TC	$263.03	$263.03	$263.03
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $436.52	Professional		$223.87	$316.23	$436.52
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $100.00 / $114.82	Professional	26	$74.13	$100.00	$114.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $213.80 / $363.08	Professional	TC	$151.36	$213.80	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $338.84 / $478.63	Professional		$213.80	$338.84	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $109.65 / $138.04	Professional	26	$64.57	$109.65	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $234.42 / $323.59	Professional	TC	$141.25	$234.42	$323.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $398.11 / $398.11	Professional		$338.84	$398.11	$398.11
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $134.90 / $134.90	Professional	26	$114.82	$134.90	$134.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $263.03 / $263.03	Professional	TC	$223.87	$263.03	$263.03