Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.09 / $67.09 / $67.09	Facility	26	$67.09	$67.09	$67.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.94 / $314.01 / $447.42	Professional		$171.94	$314.01	$447.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.72 / $69.23 / $237.26	Professional	26	$58.72	$69.23	$237.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.85 / $251.06 / $567.00	Professional	TC	$113.85	$251.06	$567.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $357.79 / $437.49 / $546.87	Professional		$357.79	$437.49	$546.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.17 / $148.16 / $185.20	Professional	26	$121.17	$148.16	$185.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.62 / $289.33 / $361.67	Professional	TC	$236.62	$289.33	$361.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $244.93 / $377.60 / $1,680.90	Professional		$244.93	$377.60	$1,680.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $128.33 / $414.94	Professional	26	$83.18	$128.33	$414.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $161.69 / $249.27 / $1,425.00	Professional	TC	$161.69	$249.27	$1,425.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $218.14 / $218.14 / $218.14	Facility	26	$218.14	$218.14	$218.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.51 / $452.32 / $618.48	Professional		$398.51	$452.32	$618.48
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $254.35 / $344.18 / $396.70	Professional		$254.35	$344.18	$396.70
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $84.53 / $110.08 / $125.50	Professional	26	$84.53	$110.08	$125.50
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $170.99 / $224.94 / $273.12	Professional	TC	$170.99	$224.94	$273.12
United Facility/Professional Professional Modifier Low / Median / High Price $226.49 / $367.40 / $473.42	Professional		$226.49	$367.40	$473.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.50 / $128.33 / $148.41	Professional	26	$77.50	$128.33	$148.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.99 / $242.53 / $334.78	Professional	TC	$148.99	$242.53	$334.78
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 $124.50 / $146.50 / $146.50	Professional	26	$124.50	$146.50	$146.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $234.90 / $276.30 / $276.30	Professional	TC	$234.90	$276.30	$276.30