Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.68 / $103.68 / $103.68	Facility	26	$103.68	$103.68	$103.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.38 / $475.00 / $598.50	Professional		$317.38	$475.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.93 / $186.78 / $544.67	Professional	26	$95.93	$186.78	$544.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.28 / $335.00 / $1,581.30	Professional	TC	$227.28	$335.00	$1,581.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.38 / $807.50 / $1,009.38	Professional		$660.38	$807.50	$1,009.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $189.04 / $231.16 / $288.95	Professional	26	$189.04	$231.16	$288.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $471.34 / $576.35 / $720.43	Professional	TC	$471.34	$576.35	$720.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $471.64 / $727.11 / $5,981.06	Professional		$471.64	$727.11	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $128.65 / $198.51 / $883.52	Professional	26	$128.65	$198.51	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $342.88 / $528.60 / $5,438.76	Professional	TC	$342.88	$528.60	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $339.50 / $339.50 / $339.50	Facility	26	$339.50	$339.50	$339.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $733.68 / $882.43 / $1,436.46	Professional		$733.68	$882.43	$1,436.46
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $483.07 / $633.65 / $879.04	Professional		$483.07	$633.65	$879.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $130.86 / $174.46 / $196.66	Professional	26	$130.86	$174.46	$196.66
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $346.79 / $460.81 / $712.70	Professional	TC	$346.79	$460.81	$712.70
United Facility/Professional Professional Modifier Low / Median / High Price $417.42 / $727.11 / $910.25	Professional		$417.42	$727.11	$910.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.24 / $198.51 / $230.98	Professional	26	$120.24	$198.51	$230.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.18 / $528.60 / $649.22	Professional	TC	$297.18	$528.60	$649.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $767.50 / $902.90 / $902.90	Professional		$767.50	$902.90	$902.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $226.30 / $266.20 / $266.20	Professional	26	$226.30	$266.20	$266.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $541.20 / $636.70 / $636.70	Professional	TC	$541.20	$636.70	$636.70