Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.25 / $52.25 / $52.25	Facility	26	$52.25	$52.25	$52.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.03 / $145.74 / $233.05	Professional		$128.03	$145.74	$233.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.17 / $52.25 / $153.97	Professional	26	$48.17	$52.25	$153.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.61 / $97.45 / $906.30	Professional	TC	$82.61	$97.45	$906.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.70 / $327.35 / $409.18	Professional		$267.70	$327.35	$409.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.16 / $116.36 / $145.44	Professional	26	$95.16	$116.36	$145.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.55 / $210.99 / $263.74	Professional	TC	$172.55	$210.99	$263.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.07 / $289.89 / $915.52	Professional		$187.07	$289.89	$915.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.73 / $98.70 / $323.73	Professional	26	$63.73	$98.70	$323.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $123.34 / $191.20 / $591.79	Professional	TC	$123.34	$191.20	$591.79
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $59.00 / $59.00	Facility	26	$59.00	$59.00	$59.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $298.17 / $306.49 / $387.92	Professional		$298.17	$306.49	$387.92
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $180.89 / $237.74 / $271.05	Professional		$180.89	$237.74	$271.05
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $63.65 / $86.24 / $98.33	Professional	26	$63.65	$86.24	$98.33
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $117.24 / $151.50 / $173.69	Professional	TC	$117.24	$151.50	$173.69
United Facility/Professional Professional Modifier Low / Median / High Price $168.97 / $282.06 / $320.91	Professional		$168.97	$282.06	$320.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.72 / $98.70 / $111.53	Professional	26	$60.72	$98.70	$111.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.25 / $191.20 / $206.64	Professional	TC	$108.25	$191.20	$206.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $268.89 / $316.30 / $316.30	Professional		$268.89	$316.30	$316.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $97.50 / $114.80 / $114.80	Professional	26	$97.50	$114.80	$114.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $171.30 / $201.60 / $201.60	Professional	TC	$171.30	$201.60	$201.60