Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $3,388.44	Professional		$316.23	$478.63	$3,388.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $169.82 / $398.11	Professional	26	$102.33	$169.82	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $323.59 / $3,090.30	Professional	TC	$208.93	$323.59	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $776.25 / $977.24	Professional		$616.60	$776.25	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $251.19 / $316.23	Professional	26	$199.53	$251.19	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $524.81 / $660.69	Professional	TC	$426.58	$524.81	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $645.65 / $1,202.26	Professional		$323.59	$645.65	$1,202.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $208.93 / $323.59	Professional	26	$125.89	$208.93	$323.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $457.09 / $5,495.41	Professional	TC	$269.15	$457.09	$5,495.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $691.83 / $831.76	Professional		$645.65	$691.83	$831.76
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $229.09 / $263.03	Professional	26	$218.78	$229.09	$263.03
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $467.74 / $575.44	Professional	TC	$426.58	$467.74	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Professional	26	$234.42	$234.42	$234.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $524.81 / $524.81	Professional	TC	$524.81	$524.81	$524.81
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $630.96 / $933.25	Professional		$416.87	$630.96	$933.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $186.21 / $208.93	Professional	26	$134.90	$186.21	$208.93
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $758.58	Professional	TC	$281.84	$416.87	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $660.69 / $954.99	Professional		$398.11	$660.69	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $194.98 / $281.84	Professional	26	$114.82	$194.98	$281.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $478.63 / $676.08	Professional	TC	$269.15	$478.63	$676.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $851.14 / $851.14	Professional		$724.44	$851.14	$851.14
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $281.84 / $281.84	Professional	26	$239.88	$281.84	$281.84
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $575.44 / $575.44	Professional	TC	$489.78	$575.44	$575.44