Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.41 / $109.41 / $109.41	Facility	26	$109.41	$109.41	$109.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $436.74 / $495.41 / $804.13	Professional		$436.74	$495.41	$804.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.81 / $140.00 / $176.40	Professional	26	$94.81	$140.00	$176.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $638.59	Professional	TC	$335.00	$368.50	$638.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $916.67 / $1,120.89 / $1,401.11	Professional		$916.67	$1,120.89	$1,401.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.56 / $242.79 / $303.49	Professional	26	$198.56	$242.79	$303.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $718.11 / $878.09 / $1,097.61	Professional	TC	$718.11	$878.09	$1,097.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $671.26 / $1,035.15 / $5,967.97	Professional		$671.26	$1,035.15	$5,967.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $135.25 / $208.51 / $937.83	Professional	26	$135.25	$208.51	$937.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $536.20 / $826.64 / $5,400.50	Professional	TC	$536.20	$826.64	$5,400.50
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $354.03 / $354.03 / $354.03	Facility	26	$354.03	$354.03	$354.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,003.11 / $1,097.17 / $1,612.15	Professional		$1,003.11	$1,097.17	$1,612.15
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $678.04 / $877.03 / $1,059.69	Professional		$678.04	$877.03	$1,059.69
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $138.88 / $184.53 / $207.01	Professional	26	$138.88	$184.53	$207.01
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $531.83 / $680.36 / $858.92	Professional	TC	$531.83	$680.36	$858.92
United Facility/Professional Professional Modifier Low / Median / High Price $581.20 / $1,035.15 / $1,225.71	Professional		$581.20	$1,035.15	$1,225.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $124.41 / $202.88 / $243.66	Professional	26	$124.41	$202.88	$243.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $454.57 / $826.64 / $1,015.25	Professional	TC	$454.57	$826.64	$1,015.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,062.30 / $1,249.80 / $1,249.80	Professional		$1,062.30	$1,249.80	$1,249.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $238.20 / $280.30 / $280.30	Professional	26	$238.20	$280.30	$280.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $824.10 / $969.50 / $969.50	Professional	TC	$824.10	$969.50	$969.50