Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $467.74 / $851.14	Professional		$323.59	$467.74	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $134.90 / $245.47	Professional	26	$70.79	$134.90	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $354.81 / $630.96	Professional	TC	$251.19	$354.81	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $812.83 / $1,000.00	Professional		$645.65	$812.83	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $162.18 / $204.17	Professional	26	$128.82	$162.18	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $645.65 / $812.83	Professional	TC	$512.86	$645.65	$812.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $851.14 / $1,698.24	Professional		$446.68	$851.14	$1,698.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $144.54 / $251.19	Professional	26	$89.13	$144.54	$251.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $676.08 / $4,897.79	Professional	TC	$363.08	$676.08	$4,897.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $707.95 / $912.01	Professional		$660.69	$707.95	$912.01
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $147.91 / $169.82	Professional	26	$141.25	$147.91	$169.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $562.34 / $741.31	Professional	TC	$524.81	$562.34	$741.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	26	$154.88	$154.88	$154.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $602.56 / $602.56	Professional	TC	$602.56	$602.56	$602.56
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $645.65 / $1,202.26	Professional		$446.68	$645.65	$1,202.26
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $117.49 / $151.36	Professional	26	$87.10	$117.49	$151.36
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $512.86 / $1,096.48	Professional	TC	$354.81	$512.86	$1,096.48
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $776.25 / $1,318.26	Professional		$407.38	$776.25	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $138.04 / $194.98	Professional	26	$83.18	$138.04	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $660.69 / $1,122.02	Professional	TC	$323.59	$660.69	$1,122.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $870.96 / $870.96	Professional		$741.31	$870.96	$870.96
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $181.97 / $181.97	Professional	26	$154.88	$181.97	$181.97
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $691.83 / $691.83	Professional	TC	$588.84	$691.83	$691.83