Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.60 / $52.60 / $52.60	Facility	26	$52.60	$52.60	$52.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.93 / $246.41 / $351.09	Professional		$123.93	$246.41	$351.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.24 / $51.10 / $261.89	Professional	26	$46.24	$51.10	$261.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.20 / $196.81 / $285.50	Professional	TC	$78.20	$196.81	$285.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.83 / $316.49 / $395.61	Professional		$258.83	$316.49	$395.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.79 / $117.13 / $146.41	Professional	26	$95.79	$117.13	$146.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.03 / $199.35 / $249.19	Professional	TC	$163.03	$199.35	$249.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $175.49 / $270.54 / $1,593.12	Professional		$175.49	$270.54	$1,593.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.33 / $100.71 / $325.83	Professional	26	$65.33	$100.71	$325.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $110.16 / $169.83 / $1,318.35	Professional	TC	$110.16	$169.83	$1,318.35
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $172.07 / $172.07 / $172.07	Facility	26	$172.07	$172.07	$172.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.93 / $325.27 / $503.00	Professional		$281.93	$325.27	$503.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $175.91 / $237.88 / $293.29	Professional		$175.91	$237.88	$293.29
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $66.50 / $86.81 / $98.98	Professional	26	$66.50	$86.81	$98.98
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $109.40 / $147.94 / $187.14	Professional	TC	$109.40	$147.94	$187.14
United Facility/Professional Professional Modifier Low / Median / High Price $163.38 / $270.54 / $300.06	Professional		$163.38	$270.54	$300.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.12 / $97.99 / $114.83	Professional	26	$61.12	$97.99	$114.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.26 / $165.24 / $184.04	Professional	TC	$102.26	$165.24	$184.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $259.89 / $305.80 / $305.80	Professional		$259.89	$305.80	$305.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $98.20 / $115.50 / $115.50	Professional	26	$98.20	$115.50	$115.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $161.69 / $190.30 / $190.30	Professional	TC	$161.69	$190.30	$190.30