Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.32 / $60.32 / $60.32	Facility	26	$60.32	$60.32	$60.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.46 / $389.06 / $427.97	Professional		$183.46	$389.06	$427.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $62.95 / $147.74	Professional	26	$52.46	$62.95	$147.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.00 / $326.12 / $358.73	Professional	TC	$131.00	$326.12	$358.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.53 / $467.75 / $584.67	Professional		$382.53	$467.75	$584.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.75 / $134.19 / $167.75	Professional	26	$109.75	$134.19	$167.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $272.77 / $333.55 / $416.94	Professional	TC	$272.77	$333.55	$416.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $280.88 / $433.03 / $2,319.03	Professional		$280.88	$433.03	$2,319.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $82.75 / $127.67 / $543.21	Professional	26	$82.75	$127.67	$543.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $198.07 / $305.36 / $1,973.17	Professional	TC	$198.07	$305.36	$1,973.17
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $216.21 / $216.21 / $216.21	Facility	26	$216.21	$216.21	$216.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $424.84 / $518.74 / $727.00	Professional		$424.84	$518.74	$727.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $283.70 / $378.27 / $466.73	Professional		$283.70	$378.27	$466.73
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $80.22 / $99.86 / $113.85	Professional	26	$80.22	$99.86	$113.85
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $198.50 / $264.67 / $378.06	Professional	TC	$198.50	$264.67	$378.06
United Facility/Professional Professional Modifier Low / Median / High Price $241.27 / $433.03 / $553.08	Professional		$241.27	$433.03	$553.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.90 / $127.67 / $144.82	Professional	26	$69.90	$127.67	$144.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.37 / $305.36 / $415.16	Professional	TC	$171.37	$305.36	$415.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $383.10 / $450.70 / $450.70	Professional		$383.10	$450.70	$450.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $112.90 / $132.90 / $132.90	Professional	26	$112.90	$132.90	$132.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $270.20 / $317.89 / $317.89	Professional	TC	$270.20	$317.89	$317.89