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 $157.72 / $315.56 / $450.50	Professional		$157.72	$315.56	$450.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.23 / $56.03 / $264.60	Professional	26	$51.23	$56.03	$264.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.50 / $259.52 / $376.52	Professional	TC	$106.50	$259.52	$376.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.88 / $403.36 / $504.21	Professional		$329.88	$403.36	$504.21
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 $222.67 / $272.27 / $340.34	Professional	TC	$222.67	$272.27	$340.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $236.71 / $364.93 / $1,882.38	Professional		$236.71	$364.93	$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 $163.43 / $251.95 / $1,906.00	Professional	TC	$163.43	$251.95	$1,906.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $191.71 / $191.71 / $191.71	Facility	26	$191.71	$191.71	$191.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $366.48 / $486.32 / $593.00	Professional		$366.48	$486.32	$593.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $242.68 / $329.15 / $380.58	Professional		$242.68	$329.15	$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 $165.91 / $222.53 / $302.58	Professional	TC	$165.91	$222.53	$302.58
United Facility/Professional Professional Modifier Low / Median / High Price $207.72 / $355.07 / $458.78	Professional		$207.72	$355.07	$458.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.30 / $112.98 / $156.83	Professional	26	$68.30	$112.98	$156.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.41 / $251.95 / $336.92	Professional	TC	$139.41	$251.95	$336.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $330.50 / $388.80 / $388.80	Professional		$330.50	$388.80	$388.80
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 $220.80 / $259.70 / $259.70	Professional	TC	$220.80	$259.70	$259.70