Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.70 / $65.70 / $65.70	Facility	26	$65.70	$65.70	$65.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.14 / $475.00 / $598.50	Professional		$62.14	$475.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.14 / $140.00 / $248.40	Professional	26	$62.14	$140.00	$248.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.78 / $335.00 / $422.10	Professional	TC	$217.78	$335.00	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $589.33 / $720.63 / $900.78	Professional		$589.33	$720.63	$900.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.26 / $145.83 / $182.29	Professional	26	$119.26	$145.83	$182.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $470.07 / $574.79 / $718.49	Professional	TC	$470.07	$574.79	$718.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $427.36 / $659.62 / $2,819.97	Professional		$427.36	$659.62	$2,819.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.47 / $125.65 / $469.00	Professional	26	$81.47	$125.65	$469.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $346.36 / $533.97 / $2,495.53	Professional	TC	$346.36	$533.97	$2,495.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $214.71 / $214.71 / $214.71	Facility	26	$214.71	$214.71	$214.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $562.59 / $656.33 / $922.17	Professional		$562.59	$656.33	$922.17
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $436.34 / $562.97 / $638.37	Professional		$436.34	$562.97	$638.37
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.95 / $108.37 / $123.56	Professional	26	$81.95	$108.37	$123.56
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $348.61 / $445.59 / $546.54	Professional	TC	$348.61	$445.59	$546.54
United Facility/Professional Professional Modifier Low / Median / High Price $374.28 / $659.62 / $772.46	Professional		$374.28	$659.62	$772.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.30 / $125.65 / $146.24	Professional	26	$76.30	$125.65	$146.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.98 / $533.97 / $629.89	Professional	TC	$297.98	$533.97	$629.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $681.90 / $802.20 / $802.20	Professional		$681.90	$802.20	$802.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $142.19 / $167.30 / $167.30	Professional	26	$142.19	$167.30	$167.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $539.70 / $635.00 / $635.00	Professional	TC	$539.70	$635.00	$635.00