Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.11 / $56.11 / $56.11	Facility	26	$56.11	$56.11	$56.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.75 / $304.60 / $496.00	Professional		$187.75	$304.60	$496.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.78 / $54.28 / $70.14	Professional	26	$48.78	$54.28	$70.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.96 / $181.61 / $364.76	Professional	TC	$138.96	$181.61	$364.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.14 / $477.06 / $596.32	Professional		$390.14	$477.06	$596.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.13 / $124.89 / $156.11	Professional	26	$102.13	$124.89	$156.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.01 / $352.17 / $440.21	Professional	TC	$288.01	$352.17	$440.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $268.37 / $415.42 / $1,627.19	Professional		$268.37	$415.42	$1,627.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.66 / $107.39 / $345.18	Professional	26	$69.66	$107.39	$345.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $198.70 / $308.02 / $1,330.47	Professional	TC	$198.70	$308.02	$1,330.47
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $185.93 / $185.93 / $185.93	Facility	26	$185.93	$185.93	$185.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.48 / $495.66 / $589.23	Professional		$426.48	$495.66	$589.23
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $267.30 / $356.36 / $398.09	Professional		$267.30	$356.36	$398.09
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $92.49 / $105.44	Professional	26	$70.80	$92.49	$105.44
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $196.51 / $261.98 / $297.83	Professional	TC	$196.51	$261.98	$297.83
United Facility/Professional Professional Modifier Low / Median / High Price $246.86 / $415.42 / $457.16	Professional		$246.86	$415.42	$457.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.11 / $107.39 / $149.34	Professional	26	$65.11	$107.39	$149.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.75 / $279.32 / $332.93	Professional	TC	$181.75	$279.32	$332.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $390.20 / $459.00 / $459.00	Professional		$390.20	$459.00	$459.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $104.60 / $123.10 / $123.10	Professional	26	$104.60	$123.10	$123.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $285.60 / $336.00 / $336.00	Professional	TC	$285.60	$336.00	$336.00