Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.03 / $59.03 / $59.03	Facility	26	$59.03	$59.03	$59.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.46 / $316.26 / $451.52	Professional		$158.46	$316.26	$451.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.35 / $59.03 / $263.70	Professional	26	$51.35	$59.03	$263.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.11 / $260.23 / $377.54	Professional	TC	$107.11	$260.23	$377.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.14 / $404.92 / $506.14	Professional		$331.14	$404.92	$506.14
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 $223.93 / $273.82 / $342.28	Professional	TC	$223.93	$273.82	$342.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $238.01 / $366.93 / $1,884.77	Professional		$238.01	$366.93	$1,884.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $73.29 / $112.98 / $434.24	Professional	26	$73.29	$112.98	$434.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $164.72 / $253.95 / $1,950.00	Professional	TC	$164.72	$253.95	$1,950.00
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 $368.61 / $489.06 / $593.00	Professional		$368.61	$489.06	$593.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $244.19 / $331.19 / $380.58	Professional		$244.19	$331.19	$380.58
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.23 / $97.59 / $111.27	Professional	26	$74.23	$97.59	$111.27
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $166.88 / $223.83 / $302.58	Professional	TC	$166.88	$223.83	$302.58
United Facility/Professional Professional Modifier Low / Median / High Price $208.91 / $366.93 / $461.64	Professional		$208.91	$366.93	$461.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.42 / $109.93 / $130.66	Professional	26	$67.42	$109.93	$130.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.21 / $253.95 / $339.06	Professional	TC	$140.21	$253.95	$339.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $332.40 / $391.10 / $391.10	Professional		$332.40	$391.10	$391.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $110.40 / $129.90 / $129.90	Professional	26	$110.40	$129.90	$129.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $222.00 / $261.20 / $261.20	Professional	TC	$222.00	$261.20	$261.20