Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	26	$64.57	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $371.54 / $1,778.28	Professional		$97.72	$371.54	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $128.82 / $181.97	Professional	26	$61.66	$128.82	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $323.59 / $691.83	Professional	TC	$234.42	$323.59	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $741.31 / $912.01	Professional		$588.84	$741.31	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $147.91 / $186.21	Professional	26	$120.23	$147.91	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $588.84 / $741.31	Professional	TC	$467.74	$588.84	$741.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $588.84 / $1,047.13	Professional		$316.23	$588.84	$1,047.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $114.82 / $190.55	Professional	26	$67.61	$114.82	$190.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $524.81 / $2,511.89	Professional	TC	$302.00	$524.81	$2,511.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $645.65 / $660.69	Professional		$588.84	$645.65	$660.69
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $134.90 / $158.49	Professional	26	$128.82	$134.90	$158.49
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $501.19 / $512.86	Professional	TC	$457.09	$501.19	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $467.74 / $467.74	Professional	TC	$467.74	$467.74	$467.74
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $588.84 / $758.58	Professional		$398.11	$588.84	$758.58
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $107.15 / $123.03	Professional	26	$79.43	$107.15	$123.03
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $467.74 / $660.69	Professional	TC	$323.59	$467.74	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $630.96 / $870.96	Professional		$371.54	$630.96	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $114.82 / $165.96	Professional	26	$67.61	$114.82	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $524.81 / $691.83	Professional	TC	$295.12	$524.81	$691.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $794.33 / $794.33	Professional		$676.08	$794.33	$794.33
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $165.96 / $165.96	Professional	26	$141.25	$165.96	$165.96
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $630.96 / $630.96	Professional	TC	$537.03	$630.96	$630.96