Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $954.99	Professional		$269.15	$371.54	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $107.15 / $186.21	Professional	26	$72.44	$107.15	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $251.19 / $562.34	Professional	TC	$169.82	$251.19	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $602.56 / $758.58	Professional		$478.63	$602.56	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $165.96 / $204.17	Professional	26	$131.83	$165.96	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $436.52 / $549.54	Professional	TC	$346.74	$436.52	$549.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $588.84 / $1,174.90	Professional		$331.13	$588.84	$1,174.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $102.33 / $181.97	Professional	26	$66.07	$102.33	$181.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $467.74 / $2,754.23	Professional	TC	$239.88	$467.74	$2,754.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $537.03 / $676.08	Professional		$489.78	$537.03	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $151.36 / $173.78	Professional	26	$141.25	$151.36	$173.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $380.19 / $512.86	Professional	TC	$354.81	$380.19	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34
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 $407.38 / $407.38 / $407.38	Professional	TC	$407.38	$407.38	$407.38
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $489.78 / $851.14	Professional		$331.13	$489.78	$851.14
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $102.33 / $138.04	Professional	26	$74.13	$102.33	$138.04
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $346.74 / $776.25	Professional	TC	$245.47	$346.74	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $562.34 / $912.01	Professional		$302.00	$562.34	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $114.82 / $162.18	Professional	26	$66.07	$114.82	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $457.09 / $776.25	Professional	TC	$218.78	$457.09	$776.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $660.69 / $660.69	Professional		$562.34	$660.69	$660.69
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $186.21 / $186.21	Professional	26	$158.49	$186.21	$186.21
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $467.74 / $467.74	Professional	TC	$398.11	$467.74	$467.74