Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.91 / $58.91 / $58.91	Facility	26	$58.91	$58.91	$58.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $157.43 / $315.56 / $450.50	Professional		$157.43	$315.56	$450.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.23 / $60.34 / $302.39	Professional	26	$51.23	$60.34	$302.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.19 / $259.87 / $377.04	Professional	TC	$106.19	$259.87	$377.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.61 / $401.81 / $502.27	Professional		$328.61	$401.81	$502.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.21 / $131.09 / $163.87	Professional	26	$107.21	$131.09	$163.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.40 / $270.72 / $338.40	Professional	TC	$221.40	$270.72	$338.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $236.28 / $364.27 / $1,882.38	Professional		$236.28	$364.27	$1,882.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $73.12 / $112.98 / $434.24	Professional	26	$73.12	$112.98	$434.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $163.00 / $251.29 / $1,576.92	Professional	TC	$163.00	$251.29	$1,576.92
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $192.23 / $192.23 / $192.23	Facility	26	$192.23	$192.23	$192.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $365.07 / $486.32 / $593.00	Professional		$365.07	$486.32	$593.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $243.05 / $329.66 / $380.58	Professional		$243.05	$329.66	$380.58
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.65 / $97.03 / $110.62	Professional	26	$74.65	$97.03	$110.62
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.95 / $221.24 / $302.58	Professional	TC	$164.95	$221.24	$302.58
United Facility/Professional Professional Modifier Low / Median / High Price $207.31 / $364.27 / $459.50	Professional		$207.31	$364.27	$459.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.30 / $112.98 / $130.66	Professional	26	$68.30	$112.98	$130.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.01 / $251.29 / $354.52	Professional	TC	$139.01	$251.29	$354.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $329.20 / $387.30 / $387.30	Professional		$329.20	$387.30	$387.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $109.70 / $129.10 / $129.10	Professional	26	$109.70	$129.10	$129.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $219.50 / $258.20 / $258.20	Professional	TC	$219.50	$258.20	$258.20