Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.72 / $70.72 / $70.72	Facility	26	$70.72	$70.72	$70.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.05 / $475.00 / $630.00	Professional		$279.05	$475.00	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.27 / $140.00 / $176.40	Professional	26	$61.27	$140.00	$176.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.78 / $335.00 / $441.00	Professional	TC	$217.78	$335.00	$441.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.30 / $801.30 / $1,001.62	Professional		$655.30	$801.30	$1,001.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.13 / $156.69 / $195.86	Professional	26	$128.13	$156.69	$195.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $498.86 / $644.61 / $805.76	Professional	TC	$498.86	$644.61	$805.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $479.81 / $740.89 / $3,077.22	Professional		$479.81	$740.89	$3,077.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.49 / $135.50 / $680.25	Professional	26	$87.49	$135.50	$680.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $392.69 / $605.39 / $2,677.57	Professional	TC	$392.69	$605.39	$2,677.57
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $228.60 / $228.60 / $228.60	Facility	26	$228.60	$228.60	$228.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $571.44 / $678.89 / $935.47	Professional		$571.44	$678.89	$935.47
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $485.68 / $626.28 / $704.72	Professional		$485.68	$626.28	$704.72
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $88.81 / $116.88 / $133.26	Professional	26	$88.81	$116.88	$133.26
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $391.11 / $499.67 / $579.65	Professional	TC	$391.11	$499.67	$579.65
United Facility/Professional Professional Modifier Low / Median / High Price $416.63 / $740.89 / $921.55	Professional		$416.63	$740.89	$921.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.20 / $135.50 / $178.03	Professional	26	$80.20	$135.50	$178.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $334.74 / $605.39 / $743.52	Professional	TC	$334.74	$605.39	$743.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $758.60 / $892.40 / $892.40	Professional		$758.60	$892.40	$892.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $153.40 / $180.40 / $180.40	Professional	26	$153.40	$180.40	$180.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $605.20 / $712.00 / $712.00	Professional	TC	$605.20	$712.00	$712.00