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 $168.76 / $372.00 / $531.45	Professional		$168.76	$372.00	$531.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.56 / $63.15 / $172.66	Professional	26	$47.56	$63.15	$172.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $121.20 / $308.85 / $448.11	Professional	TC	$121.20	$308.85	$448.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.08 / $430.51 / $538.14	Professional		$352.08	$430.51	$538.14
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 $252.48 / $308.73 / $385.91	Professional	TC	$252.48	$308.73	$385.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.77 / $417.43 / $1,940.92	Professional		$270.77	$417.43	$1,940.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.29 / $104.71 / $556.79	Professional	26	$69.29	$104.71	$556.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $202.85 / $312.72 / $1,561.11	Professional	TC	$202.85	$312.72	$1,561.11
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $218.05 / $218.05 / $218.05	Facility	26	$218.05	$218.05	$218.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $390.68 / $528.33 / $610.16	Professional		$390.68	$528.33	$610.16
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $264.77 / $337.42 / $455.40	Professional		$264.77	$337.42	$455.40
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.51 / $90.22 / $113.72	Professional	26	$73.51	$90.22	$113.72
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $188.10 / $250.21 / $339.78	Professional	TC	$188.10	$250.21	$339.78
United Facility/Professional Professional Modifier Low / Median / High Price $222.10 / $417.43 / $554.52	Professional		$222.10	$417.43	$554.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.52 / $104.71 / $137.91	Professional	26	$63.52	$104.71	$137.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.58 / $312.72 / $416.60	Professional	TC	$158.58	$312.72	$416.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $352.30 / $414.50 / $414.50	Professional		$352.30	$414.50	$414.50
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 $250.30 / $294.39 / $294.39	Professional	TC	$250.30	$294.39	$294.39