Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.37 / $86.37 / $86.37	Facility	26	$86.37	$86.37	$86.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.13 / $434.01 / $680.76	Professional		$238.13	$434.01	$680.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.97 / $86.37 / $119.82	Professional	26	$74.97	$86.37	$119.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.16 / $224.56 / $508.96	Professional	TC	$163.16	$224.56	$508.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $571.42 / $726.06 / $907.57	Professional		$571.42	$726.06	$907.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $157.33 / $192.37 / $240.47	Professional	26	$157.33	$192.37	$240.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $391.39 / $533.67 / $667.10	Professional	TC	$391.39	$533.67	$667.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $368.71 / $601.58 / $3,081.89	Professional		$368.71	$601.58	$3,081.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.54 / $165.78 / $554.78	Professional	26	$107.54	$165.78	$554.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $260.47 / $434.12 / $2,625.91	Professional	TC	$260.47	$434.12	$2,625.91
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $288.26 / $288.26 / $288.26	Facility	26	$288.26	$288.26	$288.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $553.32 / $645.07 / $864.71	Professional		$553.32	$645.07	$864.71
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $372.10 / $509.76 / $602.84	Professional		$372.10	$509.76	$602.84
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $110.27 / $143.55 / $163.66	Professional	26	$110.27	$143.55	$163.66
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $260.99 / $370.63 / $442.46	Professional	TC	$260.99	$370.63	$442.46
United Facility/Professional Professional Modifier Low / Median / High Price $374.28 / $601.58 / $683.63	Professional		$374.28	$601.58	$683.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.26 / $161.30 / $191.88	Professional	26	$100.26	$161.30	$191.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.02 / $434.12 / $467.53	Professional	TC	$274.02	$434.12	$467.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $594.90 / $699.90 / $699.90	Professional		$594.90	$699.90	$699.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $162.40 / $191.00 / $191.00	Professional	26	$162.40	$191.00	$191.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $432.50 / $508.90 / $508.90	Professional	TC	$432.50	$508.90	$508.90