Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $77.62 / $77.62	Facility	26	$57.54	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $741.31	Professional		$204.17	$309.03	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $91.20 / $218.78	Professional	26	$67.61	$91.20	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $204.17 / $457.09	Professional	TC	$138.04	$204.17	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $537.03 / $676.08	Professional		$426.58	$537.03	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $177.83 / $218.78	Professional	26	$141.25	$177.83	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $363.08 / $446.68	Professional	TC	$288.40	$363.08	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $416.87 / $794.33	Professional		$239.88	$416.87	$794.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $134.90 / $204.17	Professional	26	$72.44	$134.90	$204.17
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $309.03 / $1,995.26	Professional	TC	$194.98	$309.03	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $478.63 / $549.54	Professional		$446.68	$478.63	$549.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $162.18 / $186.21	Professional	26	$151.36	$162.18	$186.21
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $316.23 / $354.81	Professional	TC	$288.40	$316.23	$354.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	26	$169.82	$169.82	$169.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $331.13 / $331.13	Professional	TC	$331.13	$331.13	$331.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $436.52 / $549.54	Professional		$295.12	$436.52	$549.54
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $123.03 / $147.91	Professional	26	$93.33	$123.03	$147.91
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $288.40 / $457.09	Professional	TC	$199.53	$288.40	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $446.68 / $630.96	Professional		$269.15	$446.68	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $131.83 / $173.78	Professional	26	$79.43	$131.83	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $302.00 / $446.68	Professional	TC	$181.97	$302.00	$446.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $512.86 / $512.86	Professional		$426.58	$512.86	$512.86
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $169.82 / $169.82	Professional	26	$144.54	$169.82	$169.82
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $338.84 / $338.84	Professional	TC	$288.40	$338.84	$338.84