Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $1,819.70	Professional		$213.80	$426.58	$1,819.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $74.13 / $208.93	Professional	26	$64.57	$74.13	$208.93
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $269.15 / $269.15 / $269.15	Professional	52	$269.15	$269.15	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $251.19 / $562.34	Professional	TC	$123.03	$251.19	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $602.56	Professional		$380.19	$478.63	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $162.18 / $204.17	Professional	26	$128.82	$162.18	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $316.23 / $398.11	Professional	TC	$251.19	$316.23	$398.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $398.11 / $954.99	Professional		$190.55	$398.11	$954.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $138.04 / $208.93	Professional	26	$81.28	$138.04	$208.93
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $269.15 / $2,511.89	Professional	TC	$158.49	$269.15	$2,511.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $426.58 / $501.19	Professional		$398.11	$426.58	$501.19
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $147.91 / $173.78	Professional	26	$141.25	$147.91	$173.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $275.42 / $331.13	Professional	TC	$257.04	$275.42	$331.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
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 $302.00 / $302.00 / $302.00	Professional	TC	$302.00	$302.00	$302.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $758.58	Professional		$257.04	$380.19	$758.58
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $114.82 / $134.90	Professional	26	$87.10	$114.82	$134.90
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $251.19 / $660.69	Professional	TC	$165.96	$251.19	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $407.38 / $575.44	Professional		$239.88	$407.38	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $181.97	Professional	26	$74.13	$125.89	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $275.42 / $398.11	Professional	TC	$158.49	$275.42	$398.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $524.81 / $524.81	Professional		$446.68	$524.81	$524.81
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $181.97 / $181.97	Professional	26	$154.88	$181.97	$181.97
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $338.84 / $338.84	Professional	TC	$288.40	$338.84	$338.84