Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.49 / $61.49 / $61.49	Facility	26	$61.49	$61.49	$61.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.80 / $335.70 / $383.66	Professional		$184.80	$335.70	$383.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $57.89 / $92.28	Professional	26	$53.19	$57.89	$92.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.61 / $243.40 / $325.76	Professional	TC	$131.61	$243.40	$325.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $383.80 / $469.30 / $586.62	Professional		$383.80	$469.30	$586.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.02 / $135.75 / $169.68	Professional	26	$111.02	$135.75	$169.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $272.77 / $333.55 / $416.94	Professional	TC	$272.77	$333.55	$416.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $277.42 / $427.68 / $2,293.84	Professional		$277.42	$427.68	$2,293.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.88 / $116.98 / $523.40	Professional	26	$75.88	$116.98	$523.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $201.54 / $310.70 / $2,412.00	Professional	TC	$201.54	$310.70	$2,412.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $202.05 / $202.05 / $202.05	Facility	26	$202.05	$202.05	$202.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.27 / $584.30 / $718.00	Professional		$426.27	$584.30	$718.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $286.77 / $387.49 / $459.76	Professional		$286.77	$387.49	$459.76
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.66 / $101.00 / $115.15	Professional	26	$77.66	$101.00	$115.15
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $203.05 / $272.33 / $378.06	Professional	TC	$203.05	$272.33	$378.06
United Facility/Professional Professional Modifier Low / Median / High Price $243.26 / $427.68 / $542.76	Professional		$243.26	$427.68	$542.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.09 / $113.81 / $135.34	Professional	26	$71.09	$113.81	$135.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.16 / $310.70 / $415.88	Professional	TC	$172.16	$310.70	$415.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $384.40 / $452.20 / $452.20	Professional		$384.40	$452.20	$452.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.20 / $134.40 / $134.40	Professional	26	$114.20	$134.40	$134.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $270.20 / $317.89 / $317.89	Professional	TC	$270.20	$317.89	$317.89