Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.86 / $57.86 / $57.86	Facility	26	$57.86	$57.86	$57.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.97 / $249.31 / $522.50	Professional		$212.97	$249.31	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.31 / $57.86 / $154.00	Professional	26	$50.31	$57.86	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $191.45 / $368.50	Professional	TC	$162.66	$191.45	$368.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $444.70 / $543.77 / $679.71	Professional		$444.70	$543.77	$679.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.31 / $128.77 / $160.96	Professional	26	$105.31	$128.77	$160.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $339.39 / $415.00 / $518.75	Professional	TC	$339.39	$415.00	$518.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $310.76 / $508.81 / $2,955.62	Professional		$310.76	$508.81	$2,955.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.81 / $110.96 / $596.05	Professional	26	$71.81	$110.96	$596.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $238.63 / $397.85 / $2,626.86	Professional	TC	$238.63	$397.85	$2,626.86
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $188.60 / $188.60 / $188.60	Facility	26	$188.60	$188.60	$188.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $493.15 / $612.70 / $870.00	Professional		$493.15	$612.70	$870.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $334.23 / $448.30 / $638.27	Professional		$334.23	$448.30	$638.27
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $72.55 / $95.32 / $108.68	Professional	26	$72.55	$95.32	$108.68
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $253.21 / $339.62 / $537.99	Professional	TC	$253.21	$339.62	$537.99
United Facility/Professional Professional Modifier Low / Median / High Price $280.02 / $478.00 / $782.78	Professional		$280.02	$478.00	$782.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $110.96 / $128.94	Professional	26	$67.09	$110.96	$128.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $212.92 / $367.04 / $663.08	Professional	TC	$212.92	$367.04	$663.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $515.90 / $606.90 / $606.90	Professional		$515.90	$606.90	$606.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $125.10 / $147.10 / $147.10	Professional	26	$125.10	$147.10	$147.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $390.80 / $459.80 / $459.80	Professional	TC	$390.80	$459.80	$459.80