Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $83.18 / $83.18	Facility	26	$61.66	$83.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $407.38 / $1,000.00	Professional		$229.09	$407.38	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $85.11 / $263.03	Professional	26	$74.13	$85.11	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $218.78 / $512.86	Professional	TC	$158.49	$218.78	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $676.08 / $851.14	Professional		$537.03	$676.08	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $190.55 / $239.88	Professional	26	$154.88	$190.55	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $478.63 / $602.56	Professional	TC	$389.05	$478.63	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $501.19 / $1,148.15	Professional		$257.04	$501.19	$1,148.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $158.49 / $218.78	Professional	26	$89.13	$158.49	$218.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $346.74 / $2,754.23	Professional	TC	$204.17	$346.74	$2,754.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $562.34 / $645.65	Professional		$512.86	$562.34	$645.65
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $173.78 / $204.17	Professional	26	$165.96	$173.78	$204.17
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $389.05 / $436.52	Professional	TC	$346.74	$389.05	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	26	$181.97	$181.97	$181.97
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	TC	$371.54	$371.54	$371.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $489.78 / $891.25	Professional		$354.81	$489.78	$891.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $134.90 / $158.49	Professional	26	$102.33	$134.90	$158.49
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $776.25	Professional	TC	$245.47	$338.84	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $537.03 / $776.25	Professional		$323.59	$537.03	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $147.91 / $190.55	Professional	26	$89.13	$147.91	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $380.19 / $562.34	Professional	TC	$229.09	$380.19	$562.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $630.96 / $630.96	Professional		$537.03	$630.96	$630.96
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $186.21 / $186.21	Professional	26	$158.49	$186.21	$186.21
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $446.68 / $446.68	Professional	TC	$380.19	$446.68	$446.68