Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.42 / $71.42 / $71.42	Facility	26	$71.42	$71.42	$71.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.49 / $475.00 / $661.50	Professional		$309.49	$475.00	$661.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.18 / $161.00 / $458.10	Professional	26	$62.18	$161.00	$458.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.30 / $335.00 / $462.42	Professional	TC	$247.30	$335.00	$462.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.16 / $788.89 / $986.11	Professional		$645.16	$788.89	$986.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.41 / $158.24 / $197.80	Professional	26	$129.41	$158.24	$197.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $515.75 / $630.64 / $788.31	Professional	TC	$515.75	$630.64	$788.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $449.99 / $784.62 / $5,311.18	Professional		$449.99	$784.62	$5,311.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $90.72 / $137.49 / $808.00	Professional	26	$90.72	$137.49	$808.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $361.62 / $616.19 / $4,858.99	Professional	TC	$361.62	$616.19	$4,858.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $283.33 / $283.33 / $283.33	Facility	26	$283.33	$283.33	$283.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $714.47 / $904.56 / $1,396.55	Professional		$714.47	$904.56	$1,396.55
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $484.23 / $649.49 / $1,039.18	Professional		$484.23	$649.49	$1,039.18
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $95.22 / $118.02 / $149.11	Professional	26	$95.22	$118.02	$149.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $383.91 / $514.92 / $914.09	Professional	TC	$383.91	$514.92	$914.09
United Facility/Professional Professional Modifier Low / Median / High Price $406.64 / $693.73 / $1,207.09	Professional		$406.64	$693.73	$1,207.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.09 / $137.49 / $189.13	Professional	26	$83.09	$137.49	$189.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.55 / $556.24 / $1,026.98	Professional	TC	$323.55	$556.24	$1,026.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $747.40 / $879.30 / $879.30	Professional		$747.40	$879.30	$879.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.80 / $182.20 / $182.20	Professional	26	$154.80	$182.20	$182.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $592.60 / $697.10 / $697.10	Professional	TC	$592.60	$697.10	$697.10