Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.06 / $66.06 / $66.06	Facility	26	$66.06	$66.06	$66.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.62 / $190.01 / $522.50	Professional		$96.62	$190.01	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.14 / $148.50 / $384.48	Professional	26	$62.14	$148.50	$384.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $95.01 / $95.01 / $110.86	Professional	52	$95.01	$95.01	$110.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.84 / $375.20 / $2,454.62	Professional	TC	$132.84	$375.20	$2,454.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.12 / $485.59 / $606.99	Professional		$397.12	$485.59	$606.99
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 $277.86 / $339.76 / $424.70	Professional	TC	$277.86	$339.76	$424.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $277.45 / $427.76 / $2,789.74	Professional		$277.45	$427.76	$2,789.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.90 / $126.82 / $542.85	Professional	26	$81.90	$126.82	$542.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $195.20 / $300.94 / $2,451.15	Professional	TC	$195.20	$300.94	$2,451.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $219.10 / $219.10 / $219.10	Facility	26	$219.10	$219.10	$219.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $441.21 / $518.78 / $871.00	Professional		$441.21	$518.78	$871.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $283.18 / $381.05 / $467.20	Professional		$283.18	$381.05	$467.20
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $83.23 / $108.37 / $123.56	Professional	26	$83.23	$108.37	$123.56
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $199.94 / $263.66 / $329.87	Professional	TC	$199.94	$263.66	$329.87
United Facility/Professional Professional Modifier Low / Median / High Price $250.06 / $427.76 / $536.00	Professional		$250.06	$427.76	$536.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.30 / $123.39 / $147.04	Professional	26	$76.30	$123.39	$147.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.76 / $300.94 / $369.55	Professional	TC	$173.76	$300.94	$369.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $461.50 / $543.00 / $543.00	Professional		$461.50	$543.00	$543.00
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 $319.39 / $375.70 / $375.70	Professional	TC	$319.39	$375.70	$375.70