Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.72 / $86.72 / $86.72	Facility	26	$86.72	$86.72	$86.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.97 / $475.00 / $570.55	Professional		$312.97	$475.00	$570.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.16 / $140.00 / $195.80	Professional	26	$75.16	$140.00	$195.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $237.81 / $335.00 / $439.88	Professional	TC	$237.81	$335.00	$439.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $650.23 / $795.09 / $993.87	Professional		$650.23	$795.09	$993.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $157.33 / $192.37 / $240.47	Professional	26	$157.33	$192.37	$240.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $492.91 / $602.72 / $753.40	Professional	TC	$492.91	$602.72	$753.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $464.87 / $716.67 / $3,032.66	Professional		$464.87	$716.67	$3,032.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.47 / $165.78 / $854.80	Professional	26	$107.47	$165.78	$854.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $357.34 / $550.89 / $2,562.41	Professional	TC	$357.34	$550.89	$2,562.41
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $286.32 / $286.32 / $286.32	Facility	26	$286.32	$286.32	$286.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $720.87 / $870.39 / $1,061.68	Professional		$720.87	$870.39	$1,061.68
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $477.00 / $622.59 / $677.57	Professional		$477.00	$622.59	$677.57
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $109.82 / $142.97 / $163.02	Professional	26	$109.82	$142.97	$163.02
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $360.95 / $467.71 / $539.08	Professional	TC	$360.95	$467.71	$539.08
United Facility/Professional Professional Modifier Low / Median / High Price $411.43 / $716.67 / $894.58	Professional		$411.43	$716.67	$894.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.26 / $165.78 / $218.05	Professional	26	$100.26	$165.78	$218.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $311.17 / $550.89 / $676.53	Professional	TC	$311.17	$550.89	$676.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $754.10 / $887.20 / $887.20	Professional		$754.10	$887.20	$887.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $187.60 / $220.70 / $220.70	Professional	26	$187.60	$220.70	$220.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $566.50 / $666.50 / $666.50	Professional	TC	$566.50	$666.50	$666.50