Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.63 / $84.63 / $84.63	Facility	26	$84.63	$84.63	$84.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.60 / $431.44 / $615.49	Professional		$236.60	$431.44	$615.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.97 / $84.63 / $356.89	Professional	26	$77.97	$84.63	$356.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.27 / $351.12 / $509.48	Professional	TC	$163.27	$351.12	$509.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.22 / $659.35 / $824.18	Professional		$539.22	$659.35	$824.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.52 / $187.72 / $234.65	Professional	26	$153.52	$187.72	$234.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $385.70 / $471.63 / $589.53	Professional	TC	$385.70	$471.63	$589.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $353.46 / $552.85 / $3,234.12	Professional		$353.46	$552.85	$3,234.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.94 / $161.78 / $559.72	Professional	26	$104.94	$161.78	$559.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $248.40 / $391.07 / $2,749.60	Professional	TC	$248.40	$391.07	$2,749.60
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $282.32 / $282.32 / $282.32	Facility	26	$282.32	$282.32	$282.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $548.94 / $639.65 / $780.65	Professional		$548.94	$639.65	$780.65
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $356.30 / $477.75 / $586.13	Professional		$356.30	$477.75	$586.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $107.27 / $139.58 / $159.13	Professional	26	$107.27	$139.58	$159.13
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $248.93 / $335.36 / $409.15	Professional	TC	$248.93	$335.36	$409.15
United Facility/Professional Professional Modifier Low / Median / High Price $339.13 / $537.91 / $618.55	Professional		$339.13	$537.91	$618.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.86 / $157.41 / $183.86	Professional	26	$97.86	$157.41	$183.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $241.27 / $391.07 / $453.38	Professional	TC	$241.27	$391.07	$453.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $540.40 / $635.70 / $635.70	Professional		$540.40	$635.70	$635.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $157.90 / $185.70 / $185.70	Professional	26	$157.90	$185.70	$185.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $382.50 / $450.00 / $450.00	Professional	TC	$382.50	$450.00	$450.00