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 $300.04 / $475.00 / $600.08	Professional		$300.04	$475.00	$600.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.95 / $168.21 / $596.29	Professional	26	$97.95	$168.21	$596.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $203.70 / $335.00 / $422.10	Professional	TC	$203.70	$335.00	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $623.59 / $762.51 / $953.14	Professional		$623.59	$762.51	$953.14
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 $421.86 / $515.84 / $644.79	Professional	TC	$421.86	$515.84	$644.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $445.54 / $686.87 / $6,195.24	Professional		$445.54	$686.87	$6,195.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $137.44 / $212.34 / $931.20	Professional	26	$137.44	$212.34	$931.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $307.80 / $474.53 / $5,551.18	Professional	TC	$307.80	$474.53	$5,551.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $403.34 / $403.34 / $403.34	Facility	26	$403.34	$403.34	$403.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $694.54 / $834.54 / $1,485.23	Professional		$694.54	$834.54	$1,485.23
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $456.25 / $599.85 / $755.30	Professional		$456.25	$599.85	$755.30
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $140.62 / $184.41 / $210.24	Professional	26	$140.62	$184.41	$210.24
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $310.24 / $400.10 / $523.13	Professional	TC	$310.24	$400.10	$523.13
United Facility/Professional Professional Modifier Low / Median / High Price $395.05 / $686.87 / $861.88	Professional		$395.05	$686.87	$861.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.63 / $212.34 / $279.08	Professional	26	$128.63	$212.34	$279.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $266.42 / $461.70 / $582.79	Professional	TC	$266.42	$461.70	$582.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $726.60 / $854.80 / $854.80	Professional		$726.60	$854.80	$854.80
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 $484.60 / $570.10 / $570.10	Professional	TC	$484.60	$570.10	$570.10