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 $141.81 / $321.13 / $458.16	Professional		$141.81	$321.13	$458.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.36 / $78.56 / $256.80	Professional	26	$51.36	$78.56	$256.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.56 / $261.63 / $379.60	Professional	TC	$94.56	$261.63	$379.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.25 / $362.25 / $452.81	Professional		$296.25	$362.25	$452.81
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 $196.66 / $240.47 / $300.58	Professional	TC	$196.66	$240.47	$300.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $201.88 / $311.26 / $1,708.01	Professional		$201.88	$311.26	$1,708.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.78 / $104.71 / $384.71	Professional	26	$67.78	$104.71	$384.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $133.97 / $206.55 / $2,023.00	Professional	TC	$133.97	$206.55	$2,023.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $204.94 / $204.94 / $204.94	Facility	26	$204.94	$204.94	$204.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $322.52 / $373.25 / $506.00	Professional		$322.52	$373.25	$506.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $202.51 / $273.85 / $327.98	Professional		$202.51	$273.85	$327.98
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $90.22 / $102.86	Professional	26	$69.08	$90.22	$102.86
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $133.44 / $180.44 / $225.75	Professional	TC	$133.44	$180.44	$225.75
United Facility/Professional Professional Modifier Low / Median / High Price $186.95 / $311.26 / $353.28	Professional		$186.95	$311.26	$353.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.11 / $104.71 / $121.14	Professional	26	$63.11	$104.71	$121.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.84 / $206.55 / $234.67	Professional	TC	$123.84	$206.55	$234.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $297.10 / $349.60 / $349.60	Professional		$297.10	$349.60	$349.60
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 $195.10 / $229.50 / $229.50	Professional	TC	$195.10	$229.50	$229.50