Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $457.09 / $1,698.24	Professional		$177.83	$457.09	$1,698.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $158.49 / $338.84	Professional	26	$95.50	$158.49	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $416.87 / $794.33	Professional	TC	$302.00	$416.87	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $1,258.93	Professional		$794.33	$1,000.00	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $239.88 / $295.12	Professional	26	$190.55	$239.88	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $758.58 / $954.99	Professional	TC	$602.56	$758.58	$954.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $851.14 / $1,412.54	Professional		$426.58	$851.14	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $194.98 / $302.00	Professional	26	$107.15	$194.98	$302.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $676.08 / $5,495.41	Professional	TC	$398.11	$676.08	$5,495.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $891.25 / $1,096.48	Professional		$831.76	$891.25	$1,096.48
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $218.78 / $251.19	Professional	26	$204.17	$218.78	$251.19
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $660.69 / $831.76	Professional	TC	$616.60	$660.69	$831.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Professional		$977.24	$977.24	$977.24
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	26	$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $758.58 / $758.58	Professional	TC	$758.58	$758.58	$758.58
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $812.83 / $1,023.29	Professional		$537.03	$812.83	$1,023.29
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $165.96 / $199.53	Professional	26	$117.49	$165.96	$199.53
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $602.56 / $870.96	Professional	TC	$416.87	$602.56	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $870.96 / $1,174.90	Professional		$501.19	$870.96	$1,174.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $263.03	Professional	26	$107.15	$181.97	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $691.83 / $891.25	Professional	TC	$389.05	$691.83	$891.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,096.48 / $1,096.48	Professional		$933.25	$1,096.48	$1,096.48
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $269.15 / $269.15	Professional	26	$229.09	$269.15	$269.15
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $812.83 / $812.83	Professional	TC	$691.83	$812.83	$812.83