Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $47.86 / $47.86	Facility	26	$34.67	$47.86	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $158.49 / $724.44	Professional		$44.67	$158.49	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $165.96	Professional	26	$44.67	$61.66	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $131.83 / $309.03	Professional	TC	$93.33	$131.83	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $389.05 / $489.78	Professional		$316.23	$389.05	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $109.65 / $138.04	Professional	26	$87.10	$109.65	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $281.84 / $354.81	Professional	TC	$229.09	$281.84	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $288.40 / $512.86	Professional		$154.88	$288.40	$512.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $87.10 / $141.25	Professional	26	$54.95	$87.10	$141.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $223.87 / $1,096.48	Professional	TC	$131.83	$223.87	$1,096.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $331.13 / $363.08	Professional		$302.00	$331.13	$363.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $100.00 / $117.49	Professional	26	$95.50	$100.00	$117.49
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $234.42 / $245.47	Professional	TC	$204.17	$234.42	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Professional	26	$104.71	$104.71	$104.71
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	TC	$229.09	$229.09	$229.09
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $354.81	Professional		$208.93	$295.12	$354.81
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $77.62 / $91.20	Professional	26	$58.88	$77.62	$91.20
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $213.80 / $288.40	Professional	TC	$151.36	$213.80	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $446.68	Professional		$199.53	$309.03	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $107.15	Professional	26	$54.95	$85.11	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $229.09 / $323.59	Professional	TC	$141.25	$229.09	$323.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $371.54	Professional		$316.23	$371.54	$371.54
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $104.71 / $104.71	Professional	26	$89.13	$104.71	$104.71
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $263.03 / $263.03	Professional	TC	$223.87	$263.03	$263.03