Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.50 / $41.50 / $41.50	Facility	26	$41.50	$41.50	$41.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.71 / $253.19 / $592.20	Professional		$119.71	$253.19	$592.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $54.39 / $154.86	Professional	26	$37.79	$54.39	$154.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $59.86 / $59.86 / $69.89	Professional	52	$59.86	$59.86	$69.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.72 / $201.03 / $1,446.25	Professional	TC	$83.72	$201.03	$1,446.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.94 / $305.63 / $382.03	Professional		$249.94	$305.63	$382.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.48 / $92.31 / $115.39	Professional	26	$75.48	$92.31	$115.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.45 / $213.32 / $266.64	Professional	TC	$174.45	$213.32	$266.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.69 / $259.19 / $1,413.47	Professional		$167.69	$259.19	$1,413.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.47 / $79.34 / $333.52	Professional	26	$51.47	$79.34	$333.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.45 / $179.84 / $1,220.00	Professional	TC	$116.45	$179.84	$1,220.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $179.53 / $179.53 / $179.53	Facility	26	$179.53	$179.53	$179.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $267.31 / $309.87 / $426.00	Professional		$267.31	$309.87	$426.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $168.19 / $224.52 / $277.49	Professional		$168.19	$224.52	$277.49
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.91 / $70.05 / $78.27	Professional	26	$51.91	$70.05	$78.27
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $116.28 / $157.22 / $199.76	Professional	TC	$116.28	$157.22	$199.76
United Facility/Professional Professional Modifier Low / Median / High Price $157.38 / $259.19 / $286.04	Professional		$157.38	$259.19	$286.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $79.34 / $91.67	Professional	26	$47.94	$79.34	$91.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.44 / $179.84 / $203.78	Professional	TC	$109.44	$179.84	$203.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $250.30 / $294.39 / $294.39	Professional		$250.30	$294.39	$294.39
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $77.70 / $91.40 / $91.40	Professional	26	$77.70	$91.40	$91.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $203.10 / $203.10	Professional	TC	$172.60	$203.10	$203.10