Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.39 / $104.39 / $104.39	Facility	26	$104.39	$104.39	$104.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.45 / $475.00 / $658.28	Professional		$279.45	$475.00	$658.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $154.00 / $493.06	Professional	26	$90.71	$154.00	$493.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $272.60 / $335.00 / $500.38	Professional	TC	$272.60	$335.00	$500.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $751.10 / $918.43 / $1,148.04	Professional		$751.10	$918.43	$1,148.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $189.68 / $231.93 / $289.92	Professional	26	$189.68	$231.93	$289.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $561.41 / $686.49 / $858.12	Professional	TC	$561.41	$686.49	$858.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $547.86 / $844.62 / $5,981.06	Professional		$547.86	$844.62	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $129.19 / $199.17 / $894.00	Professional	26	$129.19	$199.17	$894.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $418.67 / $645.45 / $5,438.76	Professional	TC	$418.67	$645.45	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $337.59 / $337.59 / $337.59	Facility	26	$337.59	$337.59	$337.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $832.59 / $1,024.65 / $1,436.46	Professional		$832.59	$1,024.65	$1,436.46
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $556.04 / $719.08 / $868.84	Professional		$556.04	$719.08	$868.84
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $131.72 / $173.06 / $197.30	Professional	26	$131.72	$173.06	$197.30
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $416.69 / $531.63 / $676.27	Professional	TC	$416.69	$531.63	$676.27
United Facility/Professional Professional Modifier Low / Median / High Price $477.35 / $844.62 / $1,054.59	Professional		$477.35	$844.62	$1,054.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $121.03 / $199.17 / $261.85	Professional	26	$121.03	$199.17	$261.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $356.32 / $645.45 / $792.75	Professional	TC	$356.32	$645.45	$792.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $871.00 / $1,024.70 / $1,024.70	Professional		$871.00	$1,024.70	$1,024.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $227.10 / $267.10 / $267.10	Professional	26	$227.10	$267.10	$267.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $643.90 / $757.60 / $757.60	Professional	TC	$643.90	$757.60	$757.60