Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.72 / $70.72 / $70.72	Facility	26	$70.72	$70.72	$70.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.62 / $475.00 / $598.50	Professional		$214.62	$475.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.59 / $140.00 / $191.35	Professional	26	$66.59	$140.00	$191.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $107.31 / $107.31 / $125.82	Professional	52	$107.31	$107.31	$125.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.05 / $335.00 / $422.10	Professional	TC	$153.05	$335.00	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $444.70 / $543.77 / $679.71	Professional		$444.70	$543.77	$679.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.13 / $156.69 / $195.86	Professional	26	$128.13	$156.69	$195.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $316.55 / $387.07 / $483.84	Professional	TC	$316.55	$387.07	$483.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $321.64 / $495.86 / $3,507.01	Professional		$321.64	$495.86	$3,507.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.89 / $135.50 / $571.29	Professional	26	$87.89	$135.50	$571.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $234.29 / $389.44 / $2,477.29	Professional	TC	$234.29	$389.44	$2,477.29
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $234.77 / $234.77 / $234.77	Facility	26	$234.77	$234.77	$234.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $493.86 / $602.19 / $886.00	Professional		$493.86	$602.19	$886.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $329.54 / $448.95 / $648.03	Professional		$329.54	$448.95	$648.03
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $89.24 / $118.98 / $133.26	Professional	26	$89.24	$118.98	$133.26
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $235.36 / $315.69 / $518.41	Professional	TC	$235.36	$315.69	$518.41
United Facility/Professional Professional Modifier Low / Median / High Price $282.41 / $495.86 / $755.78	Professional		$282.41	$495.86	$755.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.29 / $135.50 / $178.03	Professional	26	$82.29	$135.50	$178.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.12 / $360.36 / $609.24	Professional	TC	$200.12	$360.36	$609.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $516.60 / $607.79 / $607.79	Professional		$516.60	$607.79	$607.79
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $153.40 / $180.40 / $180.40	Professional	26	$153.40	$180.40	$180.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $363.30 / $427.40 / $427.40	Professional	TC	$363.30	$427.40	$427.40