Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $85.11	Facility	26	$85.11	$85.11	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $1,862.09	Professional		$371.54	$478.63	$1,862.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $281.84	Professional	26	$81.28	$125.89	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $346.74 / $616.60	Professional	TC	$245.47	$346.74	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $831.76 / $1,023.29	Professional		$660.69	$831.76	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $194.98 / $245.47	Professional	26	$158.49	$194.98	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $630.96 / $794.33	Professional	TC	$501.19	$630.96	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $645.65 / $1,148.15	Professional		$346.74	$645.65	$1,148.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $602.56	Professional	26	$89.13	$151.36	$602.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $537.03 / $2,570.40	Professional	TC	$316.23	$537.03	$2,570.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $741.31 / $870.96	Professional		$676.08	$741.31	$870.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $181.97 / $208.93	Professional	26	$169.82	$181.97	$208.93
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $549.54 / $660.69	Professional	TC	$512.86	$549.54	$660.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	26	$181.97	$181.97	$181.97
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $602.56 / $602.56	Professional	TC	$602.56	$602.56	$602.56
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $660.69 / $794.33	Professional		$436.52	$660.69	$794.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $138.04 / $162.18	Professional	26	$104.71	$138.04	$162.18
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $501.19 / $691.83	Professional	TC	$338.84	$501.19	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $707.95 / $977.24	Professional		$416.87	$707.95	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $151.36 / $218.78	Professional	26	$91.20	$151.36	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $537.03 / $741.31	Professional	TC	$316.23	$537.03	$741.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $912.01 / $912.01	Professional		$758.58	$912.01	$912.01
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $223.87 / $223.87	Professional	26	$186.21	$223.87	$223.87
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $676.08 / $676.08	Professional	TC	$575.44	$676.08	$676.08