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 $121.06 / $247.93 / $353.78	Professional		$121.06	$247.93	$353.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.30 / $51.59 / $220.72	Professional	26	$43.30	$51.59	$220.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.13 / $201.03 / $291.63	Professional	TC	$79.13	$201.03	$291.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.48 / $308.73 / $385.91	Professional		$252.48	$308.73	$385.91
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 $164.94 / $201.68 / $252.10	Professional	TC	$164.94	$201.68	$252.10
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 $60.02 / $92.71 / $379.76	Professional	26	$60.02	$92.71	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $197.19 / $1,318.35	Professional	TC	$127.91	$197.19	$1,318.35
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $158.26 / $158.26 / $158.26	Facility	26	$158.26	$158.26	$158.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.08 / $359.75 / $509.00	Professional		$281.08	$359.75	$509.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $190.51 / $254.83 / $327.27	Professional		$190.51	$254.83	$327.27
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $60.92 / $79.44 / $90.57	Professional	26	$60.92	$79.44	$90.57
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $122.99 / $164.96 / $251.15	Professional	TC	$122.99	$164.96	$251.15
United Facility/Professional Professional Modifier Low / Median / High Price $159.38 / $289.89 / $363.02	Professional		$159.38	$289.89	$363.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $92.71 / $107.21	Professional	26	$55.92	$92.71	$107.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.46 / $197.19 / $276.13	Professional	TC	$103.46	$197.19	$276.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $253.50 / $298.20 / $298.20	Professional		$253.50	$298.20	$298.20
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 $163.60 / $192.50 / $192.50	Professional	TC	$163.60	$192.50	$192.50