Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.13 / $61.13 / $61.13	Facility	26	$61.13	$61.13	$61.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.05 / $197.05 / $423.62	Professional		$197.05	$197.05	$423.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $57.81 / $66.06	Professional	26	$53.19	$57.81	$66.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.86 / $143.86 / $188.15	Professional	TC	$143.86	$143.86	$188.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $409.81 / $501.10 / $626.38	Professional		$409.81	$501.10	$626.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.02 / $135.75 / $169.68	Professional	26	$111.02	$135.75	$169.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $298.79 / $365.35 / $456.69	Professional	TC	$298.79	$365.35	$456.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $299.66 / $461.98 / $2,220.23	Professional		$299.66	$461.98	$2,220.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.88 / $116.98 / $590.91	Professional	26	$75.88	$116.98	$590.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $223.78 / $345.00 / $1,822.59	Professional	TC	$223.78	$345.00	$1,822.59
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $226.53 / $226.53 / $226.53	Facility	26	$226.53	$226.53	$226.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $454.72 / $604.74 / $650.00	Professional		$454.72	$604.74	$650.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $308.19 / $395.83 / $498.47	Professional		$308.19	$395.83	$498.47
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.59 / $101.00 / $119.52	Professional	26	$81.59	$101.00	$119.52
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $222.34 / $298.22 / $376.95	Professional	TC	$222.34	$298.22	$376.95
United Facility/Professional Professional Modifier Low / Median / High Price $259.25 / $461.98 / $605.04	Professional		$259.25	$461.98	$605.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.09 / $116.98 / $144.38	Professional	26	$71.09	$116.98	$144.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.15 / $345.00 / $460.66	Professional	TC	$188.15	$345.00	$460.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $410.10 / $482.40 / $482.40	Professional		$410.10	$482.40	$482.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.20 / $134.40 / $134.40	Professional	26	$114.20	$134.40	$134.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $295.80 / $348.10 / $348.10	Professional	TC	$295.80	$348.10	$348.10