Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Facility	26	$57.54	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $323.59 / $549.54	Professional		$218.78	$323.59	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $72.44 / $141.25	Professional	26	$53.70	$72.44	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $239.88 / $416.87	Professional	TC	$165.96	$239.88	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $562.34 / $691.83	Professional		$446.68	$562.34	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $131.83 / $165.96	Professional	26	$104.71	$131.83	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $426.58 / $524.81	Professional	TC	$338.84	$426.58	$524.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $549.54 / $1,122.02	Professional		$309.03	$549.54	$1,122.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $102.33 / $602.56	Professional	26	$60.26	$102.33	$602.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $446.68 / $2,630.27	Professional	TC	$239.88	$446.68	$2,630.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $489.78 / $616.60	Professional		$457.09	$489.78	$616.60
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $120.23 / $138.04	Professional	26	$114.82	$120.23	$138.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $371.54 / $478.63	Professional	TC	$338.84	$371.54	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Professional		$524.81	$524.81	$524.81
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	26	$123.03	$123.03	$123.03
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $398.11 / $398.11	Professional	TC	$398.11	$398.11	$398.11
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $446.68 / $794.33	Professional		$309.03	$446.68	$794.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $93.33 / $109.65	Professional	26	$70.79	$93.33	$109.65
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $338.84 / $724.44	Professional	TC	$234.42	$338.84	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $524.81 / $851.14	Professional		$281.84	$524.81	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $102.33 / $144.54	Professional	26	$60.26	$102.33	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $426.58 / $724.44	Professional	TC	$213.80	$426.58	$724.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $602.56 / $602.56	Professional		$512.86	$602.56	$602.56
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $147.91 / $147.91	Professional	26	$125.89	$147.91	$147.91
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $457.09 / $457.09	Professional	TC	$389.05	$457.09	$457.09