Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $57.54 / $57.54	Facility	26	$41.69	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $218.78 / $524.81	Professional		$158.49	$218.78	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $199.53	Professional	26	$53.70	$61.66	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $154.88 / $295.12	Professional	TC	$107.15	$154.88	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $416.87 / $512.86	Professional		$331.13	$416.87	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $134.90 / $165.96	Professional	26	$107.15	$134.90	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $275.42 / $346.74	Professional	TC	$223.87	$275.42	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $354.81 / $645.65	Professional		$194.98	$354.81	$645.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $104.71 / $436.52	Professional	26	$60.26	$104.71	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $251.19 / $1,905.46	Professional	TC	$162.18	$251.19	$1,905.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $363.08 / $501.19	Professional		$338.84	$363.08	$501.19
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $123.03 / $141.25	Professional	26	$114.82	$123.03	$141.25
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $245.47 / $363.08	Professional	TC	$223.87	$245.47	$363.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	26	$125.89	$125.89	$125.89
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $275.42 / $275.42	Professional	TC	$275.42	$275.42	$275.42
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $331.13 / $436.52	Professional		$229.09	$331.13	$436.52
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $95.50 / $109.65	Professional	26	$70.79	$95.50	$109.65
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $223.87 / $363.08	Professional	TC	$154.88	$223.87	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $363.08 / $501.19	Professional		$208.93	$363.08	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $104.71 / $131.83	Professional	26	$60.26	$104.71	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $251.19 / $371.54	Professional	TC	$138.04	$251.19	$371.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $389.05 / $389.05	Professional		$331.13	$389.05	$389.05
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $128.82 / $128.82	Professional	26	$109.65	$128.82	$128.82
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $257.04 / $257.04	Professional	TC	$218.78	$257.04	$257.04