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 $74.41 / $81.48 / $344.43	Professional	26	$74.41	$81.48	$344.43
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 $538.58 / $658.57 / $823.21	Professional		$538.58	$658.57	$823.21
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 $385.07 / $470.85 / $588.55	Professional	TC	$385.07	$470.85	$588.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $352.61 / $552.19 / $3,248.56	Professional		$352.61	$552.19	$3,248.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.94 / $161.78 / $880.00	Professional	26	$104.94	$161.78	$880.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $247.55 / $390.41 / $2,762.21	Professional	TC	$247.55	$390.41	$2,762.21
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $280.83 / $280.83 / $280.83	Facility	26	$280.83	$280.83	$280.83
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 $355.73 / $477.18 / $582.59	Professional		$355.73	$477.18	$582.59
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $106.84 / $139.58 / $159.13	Professional	26	$106.84	$139.58	$159.13
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $248.06 / $333.03 / $406.32	Professional	TC	$248.06	$333.03	$406.32
United Facility/Professional Professional Modifier Low / Median / High Price $338.74 / $537.26 / $632.84	Professional		$338.74	$537.26	$632.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.86 / $153.09 / $183.86	Professional	26	$97.86	$153.09	$183.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $240.88 / $390.41 / $433.20	Professional	TC	$240.88	$390.41	$433.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $539.70 / $635.00 / $635.00	Professional		$539.70	$635.00	$635.00
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 $381.80 / $449.20 / $449.20	Professional	TC	$381.80	$449.20	$449.20