Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.37 / $86.37 / $86.37	Facility	26	$86.37	$86.37	$86.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.95 / $475.00 / $661.50	Professional		$316.95	$475.00	$661.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.86 / $140.00 / $176.40	Professional	26	$74.86	$140.00	$176.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.10 / $317.00 / $422.10	Professional	TC	$242.10	$317.00	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.38 / $807.50 / $1,009.38	Professional		$660.38	$807.50	$1,009.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $157.33 / $192.37 / $240.47	Professional	26	$157.33	$192.37	$240.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $503.06 / $615.13 / $768.91	Professional	TC	$503.06	$615.13	$768.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $467.04 / $720.02 / $3,014.38	Professional		$467.04	$720.02	$3,014.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $106.67 / $164.45 / $597.70	Professional	26	$106.67	$164.45	$597.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $360.37 / $555.57 / $2,544.17	Professional	TC	$360.37	$555.57	$2,544.17
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $281.81 / $281.81 / $281.81	Facility	26	$281.81	$281.81	$281.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $732.97 / $874.49 / $1,074.88	Professional		$732.97	$874.49	$1,074.88
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $479.60 / $633.04 / $681.27	Professional		$479.60	$633.04	$681.27
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $109.40 / $143.55 / $163.66	Professional	26	$109.40	$143.55	$163.66
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $367.35 / $477.54 / $550.41	Professional	TC	$367.35	$477.54	$550.41
United Facility/Professional Professional Modifier Low / Median / High Price $416.63 / $720.02 / $848.42	Professional		$416.63	$720.02	$848.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.87 / $160.00 / $192.47	Professional	26	$99.87	$160.00	$192.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.76 / $555.57 / $682.27	Professional	TC	$316.76	$555.57	$682.27
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $766.80 / $902.10 / $902.10	Professional		$766.80	$902.10	$902.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $188.30 / $221.60 / $221.60	Professional	26	$188.30	$221.60	$221.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $578.40 / $680.50 / $680.50	Professional	TC	$578.40	$680.50	$680.50