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 $194.98 / $263.03 / $537.03	Professional		$194.98	$263.03	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $154.88	Professional	26	$52.48	$69.18	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $398.11	Professional	TC	$141.25	$190.55	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $512.86 / $645.65	Professional		$407.38	$512.86	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $138.04 / $173.78	Professional	26	$112.20	$138.04	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $371.54 / $467.74	Professional	TC	$302.00	$371.54	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $446.68 / $851.14	Professional		$257.04	$446.68	$851.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $114.82 / $588.84	Professional	26	$72.44	$114.82	$588.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $346.74 / $1,819.70	Professional	TC	$218.78	$346.74	$1,819.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $457.09 / $602.56	Professional		$426.58	$457.09	$602.56
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $125.89 / $169.82	Professional	26	$120.23	$125.89	$169.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $331.13 / $436.52	Professional	TC	$302.00	$331.13	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
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 $371.54 / $371.54 / $371.54	Professional	TC	$371.54	$371.54	$371.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $416.87 / $602.56	Professional		$281.84	$416.87	$602.56
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $104.71 / $120.23	Professional	26	$77.62	$104.71	$120.23
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $295.12 / $512.86	Professional	TC	$208.93	$295.12	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $457.09 / $660.69	Professional		$257.04	$457.09	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $114.82 / $154.88	Professional	26	$70.79	$114.82	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $346.74 / $501.19	Professional	TC	$186.21	$346.74	$501.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $478.63 / $478.63	Professional		$407.38	$478.63	$478.63
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 $295.12 / $346.74 / $346.74	Professional	TC	$295.12	$346.74	$346.74