Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.19 / $62.19 / $62.19	Facility	26	$62.19	$62.19	$62.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $259.57 / $368.92	Professional		$139.66	$259.57	$368.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.80 / $62.19 / $139.72	Professional	26	$53.80	$62.19	$139.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.87 / $201.03 / $291.63	Professional	TC	$85.87	$201.03	$291.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.81 / $356.82 / $446.03	Professional		$291.81	$356.82	$446.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.92 / $138.07 / $172.59	Professional	26	$112.92	$138.07	$172.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $178.89 / $218.75 / $273.43	Professional	TC	$178.89	$218.75	$273.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.60 / $306.18 / $1,403.43	Professional		$198.60	$306.18	$1,403.43
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $76.98 / $118.98 / $384.88	Professional	26	$76.98	$118.98	$384.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $121.43 / $187.20 / $1,332.00	Professional	TC	$121.43	$187.20	$1,332.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $200.69 / $200.69 / $200.69	Facility	26	$200.69	$200.69	$200.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $325.20 / $367.66 / $447.17	Professional		$325.20	$367.66	$447.17
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $206.80 / $280.87 / $323.73	Professional		$206.80	$280.87	$323.73
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $78.08 / $102.70 / $117.09	Professional	26	$78.08	$102.70	$117.09
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $169.63 / $211.18	Professional	TC	$128.82	$169.63	$211.18
United Facility/Professional Professional Modifier Low / Median / High Price $184.15 / $297.89 / $387.72	Professional		$184.15	$297.89	$387.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.90 / $118.98 / $137.59	Professional	26	$71.90	$118.98	$137.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.25 / $187.20 / $259.39	Professional	TC	$112.25	$187.20	$259.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $293.30 / $345.00 / $345.00	Professional		$293.30	$345.00	$345.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $116.20 / $136.69 / $136.69	Professional	26	$116.20	$136.69	$136.69
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $177.10 / $208.40 / $208.40	Professional	TC	$177.10	$208.40	$208.40