Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.91 / $58.91 / $58.91	Facility	26	$58.91	$58.91	$58.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.39 / $248.00 / $423.46	Professional		$214.39	$248.00	$423.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.93 / $58.91 / $61.24	Professional	26	$50.93	$58.91	$61.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.46 / $163.46 / $362.21	Professional	TC	$163.46	$163.46	$362.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $490.37 / $599.62 / $749.52	Professional		$490.37	$599.62	$749.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.21 / $131.09 / $163.87	Professional	26	$107.21	$131.09	$163.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $383.16 / $468.52 / $585.65	Professional	TC	$383.16	$468.52	$585.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $314.02 / $508.05 / $2,195.67	Professional		$314.02	$508.05	$2,195.67
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $73.12 / $112.98 / $439.20	Professional	26	$73.12	$112.98	$439.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $240.91 / $395.07 / $1,890.23	Professional	TC	$240.91	$395.07	$1,890.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $192.25 / $192.25 / $192.25	Facility	26	$192.25	$192.25	$192.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $494.27 / $578.20 / $720.59	Professional		$494.27	$578.20	$720.59
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $316.10 / $430.04 / $502.68	Professional		$316.10	$430.04	$502.68
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.23 / $97.03 / $110.62	Professional	26	$74.23	$97.03	$110.62
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $241.18 / $327.98 / $393.65	Professional	TC	$241.18	$327.98	$393.65
United Facility/Professional Professional Modifier Low / Median / High Price $310.77 / $494.32 / $557.63	Professional		$310.77	$494.32	$557.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $112.98 / $127.95	Professional	26	$67.91	$112.98	$127.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.87 / $395.07 / $562.14	Professional	TC	$242.87	$395.07	$562.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $489.00 / $575.29 / $575.29	Professional		$489.00	$575.29	$575.29
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $109.70 / $129.10 / $129.10	Professional	26	$109.70	$129.10	$129.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $379.30 / $446.20 / $446.20	Professional	TC	$379.30	$446.20	$446.20