Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.47 / $72.47 / $72.47	Facility	26	$72.47	$72.47	$72.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.36 / $269.26 / $546.25	Professional		$230.36	$269.26	$546.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $72.47 / $154.00	Professional	26	$63.10	$72.47	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $167.25 / $196.78 / $368.50	Professional	TC	$167.25	$196.78	$368.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $480.22 / $587.20 / $734.01	Professional		$480.22	$587.20	$734.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.32 / $160.57 / $200.71	Professional	26	$131.32	$160.57	$200.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $348.91 / $426.64 / $533.29	Professional	TC	$348.91	$426.64	$533.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $334.21 / $541.46 / $3,076.60	Professional		$334.21	$541.46	$3,076.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.25 / $126.44 / $867.00	Professional	26	$72.25	$126.44	$867.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $242.95 / $427.56 / $2,747.24	Professional	TC	$242.95	$427.56	$2,747.24
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $188.22 / $188.22 / $188.22	Facility	26	$188.22	$188.22	$188.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $533.72 / $682.78 / $870.00	Professional		$533.72	$682.78	$870.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $361.73 / $485.18 / $683.69	Professional		$361.73	$485.18	$683.69
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.37 / $101.77 / $136.50	Professional	26	$73.37	$101.77	$136.50
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $259.95 / $348.68 / $582.82	Professional	TC	$259.95	$348.68	$582.82
United Facility/Professional Professional Modifier Low / Median / High Price $303.18 / $512.54 / $833.02	Professional		$303.18	$512.54	$833.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.29 / $138.84 / $150.53	Professional	26	$84.29	$138.84	$150.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.89 / $373.70 / $712.60	Professional	TC	$218.89	$373.70	$712.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $558.29 / $656.90 / $656.90	Professional		$558.29	$656.90	$656.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $157.10 / $184.80 / $184.80	Professional	26	$157.10	$184.80	$184.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $401.20 / $472.10 / $472.10	Professional	TC	$401.20	$472.10	$472.10