Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.16 / $48.16 / $48.16	Facility	26	$48.16	$48.16	$48.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.36 / $247.93 / $353.78	Professional		$121.36	$247.93	$353.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $46.89 / $147.74	Professional	26	$43.64	$46.89	$147.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $201.03 / $291.63	Professional	TC	$79.43	$201.03	$291.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.12 / $309.50 / $386.88	Professional		$253.12	$309.50	$386.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.54 / $107.05 / $133.81	Professional	26	$87.54	$107.05	$133.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.57 / $202.46 / $253.07	Professional	TC	$165.57	$202.46	$253.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.04 / $289.89 / $1,609.32	Professional		$188.04	$289.89	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.50 / $92.71 / $379.76	Professional	26	$61.50	$92.71	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $197.19 / $1,331.00	Professional	TC	$127.91	$197.19	$1,331.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $168.53 / $168.53 / $168.53	Facility	26	$168.53	$168.53	$168.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.80 / $367.33 / $509.00	Professional		$281.80	$367.33	$509.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $190.99 / $254.83 / $328.89	Professional		$190.99	$254.83	$328.89
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $63.97 / $79.44 / $90.57	Professional	26	$63.97	$79.44	$90.57
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $123.47 / $165.61 / $251.70	Professional	TC	$123.47	$165.61	$251.70
United Facility/Professional Professional Modifier Low / Median / High Price $159.78 / $289.89 / $371.64	Professional		$159.78	$289.89	$371.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $92.71 / $107.22	Professional	26	$55.92	$92.71	$107.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.86 / $197.19 / $264.42	Professional	TC	$103.86	$197.19	$264.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $254.10 / $299.00 / $299.00	Professional		$254.10	$299.00	$299.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $89.80 / $105.70 / $105.70	Professional	26	$89.80	$105.70	$105.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $164.30 / $193.30 / $193.30	Professional	TC	$164.30	$193.30	$193.30