Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.16 / $48.16 / $48.16	Facility	26	$48.16	$48.16	$48.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.69 / $120.75 / $260.51	Professional		$44.69	$120.75	$260.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.49 / $72.75 / $216.90	Professional	26	$44.49	$72.75	$216.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.81 / $201.03 / $291.63	Professional	TC	$78.81	$201.03	$291.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.48 / $308.73 / $385.91	Professional		$252.48	$308.73	$385.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.54 / $107.05 / $133.81	Professional	26	$87.54	$107.05	$133.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.94 / $201.68 / $252.10	Professional	TC	$164.94	$201.68	$252.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.18 / $288.56 / $1,378.78	Professional		$187.18	$288.56	$1,378.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.03 / $92.70 / $300.10	Professional	26	$60.03	$92.70	$300.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $127.04 / $195.86 / $1,332.00	Professional	TC	$127.04	$195.86	$1,332.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $158.77 / $158.77 / $158.77	Facility	26	$158.77	$158.77	$158.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.08 / $359.75 / $438.00	Professional		$281.08	$359.75	$438.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $190.51 / $254.19 / $295.54	Professional		$190.51	$254.19	$295.54
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $60.92 / $79.44 / $90.57	Professional	26	$60.92	$79.44	$90.57
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $122.99 / $164.96 / $212.31	Professional	TC	$122.99	$164.96	$212.31
United Facility/Professional Professional Modifier Low / Median / High Price $158.97 / $288.56 / $361.58	Professional		$158.97	$288.56	$361.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $92.70 / $107.21	Professional	26	$55.92	$92.70	$107.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.06 / $195.86 / $261.54	Professional	TC	$103.06	$195.86	$261.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $253.50 / $298.20 / $298.20	Professional		$253.50	$298.20	$298.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $89.80 / $105.70 / $105.70	Professional	26	$89.80	$105.70	$105.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $163.60 / $192.50 / $192.50	Professional	TC	$163.60	$192.50	$192.50