Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.79 / $78.79 / $78.79	Facility	26	$78.79	$78.79	$78.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.30 / $475.00 / $533.05	Professional		$177.30	$475.00	$533.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.58 / $140.00 / $340.87	Professional	26	$74.58	$140.00	$340.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.44 / $335.00 / $414.06	Professional	TC	$225.44	$335.00	$414.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $607.10 / $742.34 / $927.93	Professional		$607.10	$742.34	$927.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $143.37 / $175.31 / $219.14	Professional	26	$143.37	$175.31	$219.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $463.73 / $567.04 / $708.80	Professional	TC	$463.73	$567.04	$708.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $442.62 / $682.37 / $3,348.15	Professional		$442.62	$682.37	$3,348.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $97.57 / $151.11 / $586.14	Professional	26	$97.57	$151.11	$586.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $344.60 / $531.26 / $2,941.88	Professional	TC	$344.60	$531.26	$2,941.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $256.52 / $256.52 / $256.52	Facility	26	$256.52	$256.52	$256.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $672.47 / $825.17 / $1,086.21	Professional		$672.47	$825.17	$1,086.21
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $449.13 / $580.79 / $701.76	Professional		$449.13	$580.79	$701.76
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $99.54 / $132.54 / $148.13	Professional	26	$99.54	$132.54	$148.13
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $344.05 / $440.05 / $551.78	Professional	TC	$344.05	$440.05	$551.78
United Facility/Professional Professional Modifier Low / Median / High Price $386.27 / $663.93 / $799.13	Professional		$386.27	$663.93	$799.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.48 / $151.11 / $170.75	Professional	26	$91.48	$151.11	$170.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $294.79 / $531.26 / $652.50	Professional	TC	$294.79	$531.26	$652.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $703.50 / $827.60 / $827.60	Professional		$703.50	$827.60	$827.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $170.50 / $200.60 / $200.60	Professional	26	$170.50	$200.60	$200.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $533.00 / $627.10 / $627.10	Professional	TC	$533.00	$627.10	$627.10