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 $298.81 / $475.00 / $598.50	Professional		$298.81	$475.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.85 / $168.21 / $523.20	Professional	26	$101.85	$168.21	$523.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $202.47 / $335.00 / $1,875.23	Professional	TC	$202.47	$335.00	$1,875.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $621.04 / $759.41 / $949.26	Professional		$621.04	$759.41	$949.26
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 $419.32 / $512.74 / $640.91	Professional	TC	$419.32	$512.74	$640.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $443.81 / $684.20 / $6,146.58	Professional		$443.81	$684.20	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $137.74 / $212.34 / $921.60	Professional	26	$137.74	$212.34	$921.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $306.07 / $471.86 / $5,551.18	Professional	TC	$306.07	$471.86	$5,551.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $372.18 / $372.18 / $372.18	Facility	26	$372.18	$372.18	$372.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $691.70 / $830.63 / $1,459.73	Professional		$691.70	$830.63	$1,459.73
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $454.09 / $597.39 / $751.06	Professional		$454.09	$597.39	$751.06
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 $308.41 / $397.65 / $518.88	Professional	TC	$308.41	$397.65	$518.88
United Facility/Professional Professional Modifier Low / Median / High Price $393.46 / $684.20 / $858.60	Professional		$393.46	$684.20	$858.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $126.38 / $206.60 / $247.53	Professional	26	$126.38	$206.60	$247.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.83 / $459.11 / $579.52	Professional	TC	$264.83	$459.11	$579.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $723.60 / $851.30 / $851.30	Professional		$723.60	$851.30	$851.30
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 $481.60 / $566.60 / $566.60	Professional	TC	$481.60	$566.60	$566.60