Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.08 / $87.08 / $87.08	Facility	26	$87.08	$87.08	$87.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.00 / $475.00 / $593.23	Professional		$324.00	$475.00	$593.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.47 / $131.34 / $426.60	Professional	26	$75.47	$131.34	$426.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $248.53 / $335.00 / $461.90	Professional	TC	$248.53	$335.00	$461.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $675.61 / $826.12 / $1,032.65	Professional		$675.61	$826.12	$1,032.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $157.96 / $193.15 / $241.44	Professional	26	$157.96	$193.15	$241.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $517.65 / $632.97 / $791.21	Professional	TC	$517.65	$632.97	$791.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $472.74 / $789.28 / $5,311.18	Professional		$472.74	$789.28	$5,311.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $108.07 / $167.13 / $808.00	Professional	26	$108.07	$167.13	$808.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $364.21 / $620.50 / $4,858.99	Professional	TC	$364.21	$620.50	$4,858.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $281.83 / $281.83 / $281.83	Facility	26	$281.83	$281.83	$281.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $748.64 / $946.67 / $1,397.68	Professional		$748.64	$946.67	$1,397.68
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $507.38 / $680.54 / $1,085.60	Professional		$507.38	$680.54	$1,085.60
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $110.27 / $143.55 / $163.66	Professional	26	$110.27	$143.55	$163.66
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $385.36 / $516.87 / $914.47	Professional	TC	$385.36	$516.87	$914.47
United Facility/Professional Professional Modifier Low / Median / High Price $425.81 / $727.36 / $1,214.28	Professional		$425.81	$727.36	$1,214.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.66 / $167.13 / $193.25	Professional	26	$100.66	$167.13	$193.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $325.14 / $560.23 / $1,034.16	Professional	TC	$325.14	$560.23	$1,034.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $783.10 / $921.30 / $921.30	Professional		$783.10	$921.30	$921.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $188.30 / $221.60 / $221.60	Professional	26	$188.30	$221.60	$221.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $594.79 / $699.80 / $699.80	Professional	TC	$594.79	$699.80	$699.80