Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.77 / $71.77 / $71.77	Facility	26	$71.77	$71.77	$71.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.18 / $475.00 / $598.50	Professional		$178.18	$475.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $140.00 / $405.84	Professional	26	$66.20	$140.00	$405.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $89.09 / $89.09 / $103.94	Professional	52	$89.09	$89.09	$103.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $115.99 / $335.00 / $422.10	Professional	TC	$115.99	$335.00	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $370.48 / $453.01 / $566.26	Professional		$370.48	$453.01	$566.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $130.05 / $159.02 / $198.77	Professional	26	$130.05	$159.02	$198.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $240.43 / $293.99 / $367.49	Professional	TC	$240.43	$293.99	$367.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $262.14 / $404.13 / $2,901.82	Professional		$262.14	$404.13	$2,901.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $88.96 / $137.49 / $558.07	Professional	26	$88.96	$137.49	$558.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $172.96 / $266.64 / $2,498.98	Professional	TC	$172.96	$266.64	$2,498.98
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $252.33 / $252.33 / $252.33	Facility	26	$252.33	$252.33	$252.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $412.74 / $492.45 / $908.00	Professional		$412.74	$492.45	$908.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $268.16 / $356.47 / $442.43	Professional		$268.16	$356.47	$442.43
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $90.10 / $118.59 / $135.19	Professional	26	$90.10	$118.59	$135.19
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $175.45 / $228.02 / $293.77	Professional	TC	$175.45	$228.02	$293.77
United Facility/Professional Professional Modifier Low / Median / High Price $234.88 / $404.13 / $508.13	Professional		$234.88	$404.13	$508.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.09 / $137.49 / $159.69	Professional	26	$83.09	$137.49	$159.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.79 / $266.64 / $317.58	Professional	TC	$151.79	$266.64	$317.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $431.80 / $508.00 / $508.00	Professional		$431.80	$508.00	$508.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $155.60 / $183.00 / $183.00	Professional	26	$155.60	$183.00	$183.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $276.20 / $324.89 / $324.89	Professional	TC	$276.20	$324.89	$324.89