Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $56.23 / $56.23	Facility	26	$39.81	$56.23	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $245.47 / $478.63	Professional		$134.90	$245.47	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $173.78	Professional	26	$51.29	$66.07	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $204.17 / $380.19	Professional	TC	$138.04	$204.17	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $489.78 / $616.60	Professional		$389.05	$489.78	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $128.82 / $158.49	Professional	26	$102.33	$128.82	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $363.08 / $446.68	Professional	TC	$288.40	$363.08	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $354.81 / $630.96	Professional		$194.98	$354.81	$630.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $97.72 / $346.74	Professional	26	$57.54	$97.72	$346.74
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $281.84 / $1,318.26	Professional	TC	$165.96	$281.84	$1,318.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $436.52 / $501.19	Professional		$398.11	$436.52	$501.19
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $114.82 / $134.90	Professional	26	$109.65	$114.82	$134.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $316.23 / $363.08	Professional	TC	$295.12	$316.23	$363.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	26	$120.23	$120.23	$120.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	TC	$338.84	$338.84	$338.84
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $371.54 / $426.58	Professional		$263.03	$371.54	$426.58
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $91.20 / $104.71	Professional	26	$67.61	$91.20	$104.71
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $269.15 / $354.81	Professional	TC	$194.98	$269.15	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $380.19 / $562.34	Professional		$245.47	$380.19	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $97.72 / $125.89	Professional	26	$57.54	$97.72	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $281.84 / $416.87	Professional	TC	$181.97	$281.84	$416.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $457.09 / $457.09	Professional		$389.05	$457.09	$457.09
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $123.03 / $123.03	Professional	26	$104.71	$123.03	$123.03
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $338.84 / $338.84	Professional	TC	$288.40	$338.84	$338.84