Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $61.66 / $61.66	Facility	26	$43.65	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $436.52	Professional		$181.97	$239.88	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $112.20	Professional	26	$51.29	$64.57	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $169.82 / $371.54	Professional	TC	$128.82	$169.82	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $602.56	Professional		$380.19	$478.63	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $138.04 / $173.78	Professional	26	$112.20	$138.04	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $338.84 / $426.58	Professional	TC	$275.42	$338.84	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $416.87 / $776.25	Professional		$229.09	$416.87	$776.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $107.15 / $524.81	Professional	26	$63.10	$107.15	$524.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $309.03 / $2,398.83	Professional	TC	$199.53	$309.03	$2,398.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $426.58 / $588.84	Professional		$398.11	$426.58	$588.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $125.89 / $147.91	Professional	26	$120.23	$125.89	$147.91
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $302.00 / $436.52	Professional	TC	$275.42	$302.00	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Professional	26	$131.83	$131.83	$131.83
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	TC	$338.84	$338.84	$338.84
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $537.03	Professional		$269.15	$389.05	$537.03
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $97.72 / $114.82	Professional	26	$74.13	$97.72	$114.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $457.09	Professional	TC	$190.55	$275.42	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $426.58 / $588.84	Professional		$245.47	$426.58	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $107.15 / $138.04	Professional	26	$64.57	$107.15	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $309.03 / $457.09	Professional	TC	$173.78	$309.03	$457.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $457.09 / $457.09	Professional		$380.19	$457.09	$457.09
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $134.90 / $134.90	Professional	26	$114.82	$134.90	$134.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $316.23 / $316.23	Professional	TC	$269.15	$316.23	$316.23