Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.11 / $56.11 / $56.11	Facility	26	$56.11	$56.11	$56.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.24 / $299.31 / $495.07	Professional		$212.24	$299.31	$495.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.78 / $58.49 / $201.14	Professional	26	$48.78	$58.49	$201.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.46 / $246.13 / $357.09	Professional	TC	$163.46	$246.13	$357.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $443.43 / $542.21 / $677.77	Professional		$443.43	$542.21	$677.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.13 / $124.89 / $156.11	Professional	26	$102.13	$124.89	$156.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $341.29 / $417.33 / $521.66	Professional	TC	$341.29	$417.33	$521.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $272.68 / $452.14 / $1,817.09	Professional		$272.68	$452.14	$1,817.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.66 / $107.39 / $364.90	Professional	26	$69.66	$107.39	$364.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $203.00 / $338.34 / $1,526.12	Professional	TC	$203.00	$338.34	$1,526.12
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $183.09 / $183.09 / $183.09	Facility	26	$183.09	$183.09	$183.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $434.93 / $519.90 / $653.34	Professional		$434.93	$519.90	$653.34
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $274.76 / $379.43 / $447.38	Professional		$274.76	$379.43	$447.38
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $92.49 / $105.44	Professional	26	$70.80	$92.49	$105.44
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $203.27 / $289.80 / $342.78	Professional	TC	$203.27	$289.80	$342.78
United Facility/Professional Professional Modifier Low / Median / High Price $281.62 / $452.14 / $496.87	Professional		$281.62	$452.14	$496.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.12 / $107.39 / $124.23	Professional	26	$65.12	$107.39	$124.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.50 / $335.43 / $355.25	Professional	TC	$216.50	$335.43	$355.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $442.80 / $521.00 / $521.00	Professional		$442.80	$521.00	$521.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $104.60 / $123.10 / $123.10	Professional	26	$104.60	$123.10	$123.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $338.20 / $397.90 / $397.90	Professional	TC	$338.20	$397.90	$397.90