Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $426.58 / $977.24	Professional		$208.93	$426.58	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $120.23 / $239.88	Professional	26	$66.07	$120.23	$239.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $870.96 / $870.96 / $870.96	Professional	52	$870.96	$870.96	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $302.00 / $812.83	Professional	TC	$123.03	$302.00	$812.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $467.74 / $575.44	Professional		$371.54	$467.74	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $162.18 / $204.17	Professional	26	$128.82	$162.18	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $302.00 / $380.19	Professional	TC	$239.88	$302.00	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $380.19 / $851.14	Professional		$190.55	$380.19	$851.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $138.04 / $208.93	Professional	26	$81.28	$138.04	$208.93
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $257.04 / $2,511.89	Professional	TC	$151.36	$257.04	$2,511.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $416.87 / $489.78	Professional		$380.19	$416.87	$489.78
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $147.91 / $173.78	Professional	26	$141.25	$147.91	$173.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $263.03 / $323.59	Professional	TC	$245.47	$263.03	$323.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	26	$154.88	$154.88	$154.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $288.40 / $288.40	Professional	TC	$288.40	$288.40	$288.40
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $371.54 / $676.08	Professional		$251.19	$371.54	$676.08
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $117.49 / $134.90	Professional	26	$87.10	$117.49	$134.90
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $239.88 / $575.44	Professional	TC	$162.18	$239.88	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $407.38 / $562.34	Professional		$234.42	$407.38	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $181.97	Professional	26	$74.13	$125.89	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $269.15 / $380.19	Professional	TC	$151.36	$269.15	$380.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $512.86 / $512.86	Professional		$436.52	$512.86	$512.86
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $181.97 / $181.97	Professional	26	$154.88	$181.97	$181.97
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $323.59 / $323.59	Professional	TC	$275.42	$323.59	$323.59