Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.49 / $61.49 / $61.49	Facility	26	$61.49	$61.49	$61.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.94 / $201.49 / $634.57	Professional		$171.94	$201.49	$634.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $70.12 / $306.74	Professional	26	$53.19	$70.12	$306.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.75 / $140.01 / $541.40	Professional	TC	$118.75	$140.01	$541.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.42 / $438.27 / $547.84	Professional		$358.42	$438.27	$547.84
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 $247.41 / $302.52 / $378.15	Professional	TC	$247.41	$302.52	$378.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $246.24 / $379.62 / $2,075.08	Professional		$246.24	$379.62	$2,075.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $76.13 / $117.64 / $460.66	Professional	26	$76.13	$117.64	$460.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $169.93 / $261.98 / $1,685.33	Professional	TC	$169.93	$261.98	$1,685.33
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $224.73 / $224.73 / $224.73	Facility	26	$224.73	$224.73	$224.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $392.95 / $454.32 / $627.47	Professional		$392.95	$454.32	$627.47
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $246.28 / $333.03 / $396.70	Professional		$246.28	$333.03	$396.70
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.23 / $101.00 / $115.15	Professional	26	$77.23	$101.00	$115.15
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $169.04 / $228.60 / $283.67	Professional	TC	$169.04	$228.60	$283.67
United Facility/Professional Professional Modifier Low / Median / High Price $226.49 / $379.62 / $419.21	Professional		$226.49	$379.62	$419.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.09 / $114.46 / $133.22	Professional	26	$71.09	$114.46	$133.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.38 / $261.98 / $297.99	Professional	TC	$155.38	$261.98	$297.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $359.40 / $422.80 / $422.80	Professional		$359.40	$422.80	$422.80
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 $245.10 / $288.39 / $288.39	Professional	TC	$245.10	$288.39	$288.39