Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.82 / $110.82 / $110.82	Facility	26	$110.82	$110.82	$110.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.89 / $475.00 / $598.50	Professional		$297.89	$475.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.21 / $162.29 / $520.79	Professional	26	$100.21	$162.29	$520.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $148.94 / $148.94 / $174.43	Professional	52	$148.94	$148.94	$174.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $201.86 / $335.00 / $3,705.96	Professional	TC	$201.86	$335.00	$3,705.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $620.41 / $758.63 / $948.29	Professional		$620.41	$758.63	$948.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $201.10 / $245.90 / $307.37	Professional	26	$201.10	$245.90	$307.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $419.32 / $512.74 / $640.91	Professional	TC	$419.32	$512.74	$640.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $441.22 / $680.21 / $6,146.58	Professional		$441.22	$680.21	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $137.74 / $212.34 / $409.50	Professional	26	$137.74	$212.34	$409.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $303.48 / $467.87 / $5,551.18	Professional	TC	$303.48	$467.87	$5,551.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $371.11 / $371.11 / $371.11	Facility	26	$371.11	$371.11	$371.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $690.98 / $826.73 / $1,459.73	Professional		$690.98	$826.73	$1,459.73
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $451.93 / $596.78 / $748.93	Professional		$451.93	$596.78	$748.93
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $139.87 / $183.84 / $209.60	Professional	26	$139.87	$183.84	$209.60
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $307.04 / $397.65 / $518.16	Professional	TC	$307.04	$397.65	$518.16
United Facility/Professional Professional Modifier Low / Median / High Price $392.26 / $680.21 / $796.57	Professional		$392.26	$680.21	$796.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.22 / $206.60 / $245.59	Professional	26	$128.22	$206.60	$245.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.04 / $467.87 / $574.60	Professional	TC	$264.04	$467.87	$574.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $722.80 / $850.40 / $850.40	Professional		$722.80	$850.40	$850.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $241.20 / $283.80 / $283.80	Professional	26	$241.20	$283.80	$283.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $481.60 / $566.60 / $566.60	Professional	TC	$481.60	$566.60	$566.60