Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $102.33 / $102.33	Facility	26	$102.33	$102.33	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $3,467.37	Professional		$371.54	$478.63	$3,467.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $208.93 / $537.03	Professional	26	$95.50	$208.93	$537.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $346.74 / $2,041.74	Professional	TC	$269.15	$346.74	$2,041.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $831.76 / $1,023.29	Professional		$660.69	$831.76	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $234.42 / $295.12	Professional	26	$190.55	$234.42	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $588.84 / $741.31	Professional	TC	$467.74	$588.84	$741.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $707.95 / $1,288.25	Professional		$354.81	$707.95	$1,288.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $302.00	Professional	26	$107.15	$181.97	$302.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $524.81 / $5,495.41	Professional	TC	$309.03	$524.81	$5,495.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $741.31 / $891.25	Professional		$676.08	$741.31	$891.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $218.78 / $245.47	Professional	26	$204.17	$218.78	$245.47
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $512.86 / $630.96	Professional	TC	$478.63	$512.86	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	26	$218.78	$218.78	$218.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $575.44 / $575.44	Professional	TC	$575.44	$575.44	$575.44
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $660.69 / $1,000.00	Professional		$446.68	$660.69	$1,000.00
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $173.78 / $204.17	Professional	26	$125.89	$173.78	$204.17
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $467.74 / $870.96	Professional	TC	$331.13	$467.74	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $724.44 / $1,000.00	Professional		$416.87	$724.44	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $263.03	Professional	26	$107.15	$181.97	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $524.81 / $776.25	Professional	TC	$295.12	$524.81	$776.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $912.01 / $912.01	Professional		$776.25	$912.01	$912.01
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $269.15 / $269.15	Professional	26	$223.87	$269.15	$269.15
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $630.96 / $630.96	Professional	TC	$537.03	$630.96	$630.96