Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.93 / $83.93 / $83.93	Facility	26	$83.93	$83.93	$83.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.30 / $295.42 / $546.25	Professional		$251.30	$295.42	$546.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.41 / $83.93 / $154.00	Professional	26	$72.41	$83.93	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.89 / $211.50 / $368.50	Professional	TC	$178.89	$211.50	$368.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $523.36 / $639.95 / $799.94	Professional		$523.36	$639.95	$799.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $151.62 / $185.39 / $231.74	Professional	26	$151.62	$185.39	$231.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.74 / $454.56 / $568.20	Professional	TC	$371.74	$454.56	$568.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $375.49 / $578.88 / $3,389.77	Professional		$375.49	$578.88	$3,389.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.08 / $160.44 / $657.14	Professional	26	$104.08	$160.44	$657.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $271.95 / $424.46 / $2,953.83	Professional	TC	$271.95	$424.46	$2,953.83
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $272.52 / $272.52 / $272.52	Facility	26	$272.52	$272.52	$272.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $581.39 / $702.79 / $1,059.00	Professional		$581.39	$702.79	$1,059.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $384.90 / $513.20 / $680.15	Professional		$384.90	$513.20	$680.15
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $103.49 / $137.88 / $157.19	Professional	26	$103.49	$137.88	$157.19
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $276.83 / $371.32 / $533.86	Professional	TC	$276.83	$371.32	$533.86
United Facility/Professional Professional Modifier Low / Median / High Price $330.74 / $578.88 / $826.68	Professional		$330.74	$578.88	$826.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.67 / $160.44 / $210.83	Professional	26	$96.67	$160.44	$210.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.07 / $418.43 / $685.67	Professional	TC	$234.07	$418.43	$685.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $608.20 / $715.50 / $715.50	Professional		$608.20	$715.50	$715.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $180.90 / $212.80 / $212.80	Professional	26	$180.90	$212.80	$212.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $427.30 / $502.70 / $502.70	Professional	TC	$427.30	$502.70	$502.70