Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $85.11	Facility	26	$85.11	$85.11	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $416.87 / $977.24	Professional		$295.12	$416.87	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $269.15	Professional	26	$81.28	$125.89	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $269.15 / $478.63	Professional	TC	$181.97	$269.15	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $660.69 / $831.76	Professional		$524.81	$660.69	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $194.98 / $245.47	Professional	26	$158.49	$194.98	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $457.09 / $575.44	Professional	TC	$371.54	$457.09	$575.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $549.54 / $1,047.13	Professional		$275.42	$549.54	$1,047.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $660.69	Professional	26	$89.13	$151.36	$660.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $398.11 / $3,019.95	Professional	TC	$234.42	$398.11	$3,019.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $588.84 / $707.95	Professional		$549.54	$588.84	$707.95
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $181.97 / $208.93	Professional	26	$169.82	$181.97	$208.93
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $407.38 / $501.19	Professional	TC	$371.54	$407.38	$501.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	26	$186.21	$186.21	$186.21
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $457.09 / $457.09	Professional	TC	$457.09	$457.09	$457.09
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $524.81 / $831.76	Professional		$354.81	$524.81	$831.76
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $141.25 / $162.18	Professional	26	$104.71	$141.25	$162.18
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $371.54 / $707.95	Professional	TC	$251.19	$371.54	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $562.34 / $776.25	Professional		$331.13	$562.34	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $218.78	Professional	26	$89.13	$151.36	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $416.87 / $588.84	Professional	TC	$234.42	$416.87	$588.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $724.44 / $724.44	Professional		$616.60	$724.44	$724.44
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $223.87 / $223.87	Professional	26	$186.21	$223.87	$223.87
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $501.19 / $501.19	Professional	TC	$426.58	$501.19	$501.19