Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.19 / $62.19 / $62.19	Facility	26	$62.19	$62.19	$62.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.05 / $259.57 / $368.92	Professional		$148.05	$259.57	$368.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.17 / $91.45 / $214.49	Professional	26	$56.17	$91.45	$214.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.94 / $201.03 / $491.28	Professional	TC	$93.94	$201.03	$491.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $308.94 / $377.77 / $472.21	Professional		$308.94	$377.77	$472.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.92 / $138.07 / $172.59	Professional	26	$112.92	$138.07	$172.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.02 / $239.69 / $299.61	Professional	TC	$196.02	$239.69	$299.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $242.34 / $373.61 / $1,670.68	Professional		$242.34	$373.61	$1,670.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $76.73 / $118.31 / $520.49	Professional	26	$76.73	$118.31	$520.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.60 / $255.30 / $1,318.41	Professional	TC	$165.60	$255.30	$1,318.41
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $202.85 / $202.85 / $202.85	Facility	26	$202.85	$202.85	$202.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $339.24 / $392.65 / $472.00	Professional		$339.24	$392.65	$472.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $233.43 / $297.47 / $385.20	Professional		$233.43	$297.47	$385.20
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $78.08 / $102.70 / $117.09	Professional	26	$78.08	$102.70	$117.09
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $146.13 / $196.01 / $277.83	Professional	TC	$146.13	$196.01	$277.83
United Facility/Professional Professional Modifier Low / Median / High Price $195.34 / $363.51 / $468.82	Professional		$195.34	$363.51	$468.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.30 / $118.31 / $136.87	Professional	26	$72.30	$118.31	$136.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.04 / $255.30 / $340.50	Professional	TC	$123.04	$255.30	$340.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $310.60 / $365.40 / $365.40	Professional		$310.60	$365.40	$365.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $116.20 / $136.69 / $136.69	Professional	26	$116.20	$136.69	$136.69
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $194.50 / $228.80 / $228.80	Professional	TC	$194.50	$228.80	$228.80