Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.22 / $58.22 / $58.22	Facility	26	$58.22	$58.22	$58.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.26 / $475.00 / $532.00	Professional		$202.26	$475.00	$532.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.31 / $130.83 / $154.00	Professional	26	$50.31	$130.83	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.94 / $335.00 / $373.65	Professional	TC	$151.94	$335.00	$373.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.86 / $515.84 / $644.79	Professional		$421.86	$515.84	$644.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.94 / $129.54 / $161.93	Professional	26	$105.94	$129.54	$161.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $315.92 / $386.30 / $482.87	Professional	TC	$315.92	$386.30	$482.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $298.82 / $516.27 / $2,961.02	Professional		$298.82	$516.27	$2,961.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.26 / $111.63 / $505.24	Professional	26	$72.26	$111.63	$505.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $226.07 / $404.30 / $2,631.72	Professional	TC	$226.07	$404.30	$2,631.72
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $190.41 / $190.41 / $190.41	Facility	26	$190.41	$190.41	$190.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $468.25 / $619.71 / $870.00	Professional		$468.25	$619.71	$870.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $317.35 / $425.66 / $659.03	Professional		$317.35	$425.66	$659.03
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $72.94 / $97.24 / $109.33	Professional	26	$72.94	$97.24	$109.33
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $235.84 / $316.33 / $550.97	Professional	TC	$235.84	$316.33	$550.97
United Facility/Professional Professional Modifier Low / Median / High Price $266.02 / $459.32 / $794.26	Professional		$266.02	$459.32	$794.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.08 / $108.61 / $129.71	Professional	26	$60.08	$108.61	$129.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.92 / $347.69 / $673.84	Professional	TC	$198.92	$347.69	$673.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $489.80 / $576.29 / $576.29	Professional		$489.80	$576.29	$576.29
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $125.80 / $148.00 / $148.00	Professional	26	$125.80	$148.00	$148.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $364.00 / $428.30 / $428.30	Professional	TC	$364.00	$428.30	$428.30