Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.74 / $86.74 / $86.74	Facility	26	$86.74	$86.74	$86.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.85 / $302.14 / $522.50	Professional		$257.85	$302.14	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.28 / $86.74 / $154.00	Professional	26	$75.28	$86.74	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $182.57 / $215.41 / $368.50	Professional	TC	$182.57	$215.41	$368.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $536.04 / $655.47 / $819.33	Professional		$536.04	$655.47	$819.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $157.96 / $193.15 / $241.44	Professional	26	$157.96	$193.15	$241.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $378.09 / $462.32 / $577.90	Professional	TC	$378.09	$462.32	$577.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $381.56 / $588.24 / $3,482.54	Professional		$381.56	$588.24	$3,482.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.21 / $165.78 / $642.27	Professional	26	$107.21	$165.78	$642.27
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $274.02 / $422.46 / $2,996.90	Professional	TC	$274.02	$422.46	$2,996.90
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $302.42 / $302.42 / $302.42	Facility	26	$302.42	$302.42	$302.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $596.33 / $712.81 / $1,091.00	Professional		$596.33	$712.81	$1,091.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $389.16 / $515.03 / $642.04	Professional		$389.16	$515.03	$642.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $109.40 / $144.12 / $164.31	Professional	26	$109.40	$144.12	$164.31
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $277.33 / $358.93 / $461.53	Professional	TC	$277.33	$358.93	$461.53
United Facility/Professional Professional Modifier Low / Median / High Price $339.53 / $588.24 / $711.22	Professional		$339.53	$588.24	$711.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.66 / $165.78 / $201.20	Professional	26	$100.66	$165.78	$201.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $238.87 / $422.46 / $518.71	Professional	TC	$238.87	$422.46	$518.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $623.79 / $733.90 / $733.90	Professional		$623.79	$733.90	$733.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $189.10 / $222.50 / $222.50	Professional	26	$189.10	$222.50	$222.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $434.70 / $511.50 / $511.50	Professional	TC	$434.70	$511.50	$511.50