Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.39 / $86.39 / $86.39	Facility	26	$86.39	$86.39	$86.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.14 / $475.00 / $661.50	Professional		$253.14	$475.00	$661.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.86 / $154.00 / $232.29	Professional	26	$74.86	$154.00	$232.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $126.57 / $126.57 / $148.16	Professional	52	$126.57	$126.57	$148.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.28 / $238.28 / $462.42	Professional	TC	$178.28	$238.28	$462.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $527.79 / $645.38 / $806.73	Professional		$527.79	$645.38	$806.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $156.69 / $191.60 / $239.50	Professional	26	$156.69	$191.60	$239.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.11 / $453.78 / $567.23	Professional	TC	$371.11	$453.78	$567.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $373.33 / $575.54 / $3,445.62	Professional		$373.33	$575.54	$3,445.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.10 / $165.11 / $672.00	Professional	26	$107.10	$165.11	$672.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $266.23 / $410.44 / $2,996.90	Professional	TC	$266.23	$410.44	$2,996.90
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $279.49 / $279.49 / $279.49	Facility	26	$279.49	$279.49	$279.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $586.39 / $700.06 / $1,076.00	Professional		$586.39	$700.06	$1,076.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $383.17 / $506.43 / $634.97	Professional		$383.17	$506.43	$634.97
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $109.40 / $142.41 / $162.37	Professional	26	$109.40	$142.41	$162.37
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $270.94 / $352.17 / $454.46	Professional	TC	$270.94	$352.17	$454.46
United Facility/Professional Professional Modifier Low / Median / High Price $333.14 / $575.54 / $700.26	Professional		$333.14	$575.54	$700.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.86 / $165.11 / $192.52	Professional	26	$99.86	$165.11	$192.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $233.28 / $410.44 / $488.23	Professional	TC	$233.28	$410.44	$488.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $613.40 / $721.70 / $721.70	Professional		$613.40	$721.70	$721.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $186.90 / $219.80 / $219.80	Professional	26	$186.90	$219.80	$219.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $426.60 / $501.80 / $501.80	Professional	TC	$426.60	$501.80	$501.80