Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.82 / $110.82 / $110.82	Facility	26	$110.82	$110.82	$110.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.42 / $475.00 / $598.50	Professional		$299.42	$475.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.53 / $199.18 / $603.00	Professional	26	$102.53	$199.18	$603.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $203.09 / $335.00 / $422.10	Professional	TC	$203.09	$335.00	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $622.32 / $760.96 / $951.20	Professional		$622.32	$760.96	$951.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $201.73 / $246.67 / $308.33	Professional	26	$201.73	$246.67	$308.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $420.59 / $514.29 / $642.86	Professional	TC	$420.59	$514.29	$642.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $444.67 / $685.54 / $6,199.75	Professional		$444.67	$685.54	$6,199.75
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $137.44 / $212.35 / $931.20	Professional	26	$137.44	$212.35	$931.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $306.93 / $473.19 / $5,551.18	Professional	TC	$306.93	$473.19	$5,551.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $407.10 / $407.10 / $407.10	Facility	26	$407.10	$407.10	$407.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $693.11 / $832.21 / $1,484.12	Professional		$693.11	$832.21	$1,484.12
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $454.96 / $598.62 / $753.18	Professional		$454.96	$598.62	$753.18
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $139.87 / $184.41 / $210.24	Professional	26	$139.87	$184.41	$210.24
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $309.32 / $398.88 / $522.41	Professional	TC	$309.32	$398.88	$522.41
United Facility/Professional Professional Modifier Low / Median / High Price $394.26 / $667.01 / $830.55	Professional		$394.26	$667.01	$830.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.63 / $212.35 / $246.76	Professional	26	$128.63	$212.35	$246.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $265.63 / $460.40 / $581.15	Professional	TC	$265.63	$460.40	$581.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $725.10 / $853.00 / $853.00	Professional		$725.10	$853.00	$853.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $241.90 / $284.60 / $284.60	Professional	26	$241.90	$284.60	$284.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $483.10 / $568.40 / $568.40	Professional	TC	$483.10	$568.40	$568.40