Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.39 / $86.39 / $86.39	Facility	26	$86.39	$86.39	$86.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.25 / $296.81 / $532.00	Professional		$253.25	$296.81	$532.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.97 / $86.39 / $156.80	Professional	26	$74.97	$86.39	$156.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.28 / $210.43 / $368.50	Professional	TC	$178.28	$210.43	$368.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $526.53 / $643.83 / $804.79	Professional		$526.53	$643.83	$804.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $157.33 / $192.37 / $240.47	Professional	26	$157.33	$192.37	$240.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $369.21 / $451.46 / $564.32	Professional	TC	$369.21	$451.46	$564.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $375.49 / $578.88 / $3,447.72	Professional		$375.49	$578.88	$3,447.72
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.10 / $165.11 / $665.40	Professional	26	$107.10	$165.11	$665.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $268.39 / $413.77 / $2,996.90	Professional	TC	$268.39	$413.77	$2,996.90
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $281.48 / $281.48 / $281.48	Facility	26	$281.48	$281.48	$281.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $585.66 / $704.24 / $1,077.00	Professional		$585.66	$704.24	$1,077.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $384.43 / $505.82 / $634.26	Professional		$384.43	$505.82	$634.26
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $109.40 / $143.55 / $163.66	Professional	26	$109.40	$143.55	$163.66
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $270.94 / $350.32 / $453.76	Professional	TC	$270.94	$350.32	$453.76
United Facility/Professional Professional Modifier Low / Median / High Price $333.54 / $578.88 / $682.00	Professional		$333.54	$578.88	$682.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.44 / $160.65 / $192.77	Professional	26	$98.44	$160.65	$192.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $233.28 / $413.77 / $508.17	Professional	TC	$233.28	$413.77	$508.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $612.70 / $720.80 / $720.80	Professional		$612.70	$720.80	$720.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $188.30 / $221.60 / $221.60	Professional	26	$188.30	$221.60	$221.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $424.30 / $499.20 / $499.20	Professional	TC	$424.30	$499.20	$499.20