Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.11 / $56.11 / $56.11	Facility	26	$56.11	$56.11	$56.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.04 / $283.45 / $338.16	Professional		$90.04	$283.45	$338.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.78 / $58.49 / $156.60	Professional	26	$48.78	$58.49	$156.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.81 / $254.24 / $368.85	Professional	TC	$106.81	$254.24	$368.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.80 / $397.16 / $496.45	Professional		$324.80	$397.16	$496.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.13 / $124.89 / $156.11	Professional	26	$102.13	$124.89	$156.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.67 / $272.27 / $340.34	Professional	TC	$222.67	$272.27	$340.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $234.38 / $361.34 / $1,638.03	Professional		$234.38	$361.34	$1,638.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.66 / $107.39 / $376.34	Professional	26	$69.66	$107.39	$376.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $164.72 / $253.95 / $1,335.34	Professional	TC	$164.72	$253.95	$1,335.34
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $183.28 / $183.28 / $183.28	Facility	26	$183.28	$183.28	$183.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $360.80 / $470.79 / $510.77	Professional		$360.80	$470.79	$510.77
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $240.67 / $326.08 / $372.82	Professional		$240.67	$326.08	$372.82
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $92.49 / $105.44	Professional	26	$70.80	$92.49	$105.44
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $165.91 / $222.53 / $275.48	Professional	TC	$165.91	$222.53	$275.48
United Facility/Professional Professional Modifier Low / Median / High Price $204.91 / $361.34 / $454.46	Professional		$204.91	$361.34	$454.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.11 / $104.49 / $124.24	Professional	26	$65.11	$104.49	$124.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.80 / $253.95 / $338.34	Professional	TC	$139.80	$253.95	$338.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $325.39 / $382.80 / $382.80	Professional		$325.39	$382.80	$382.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $104.60 / $123.10 / $123.10	Professional	26	$104.60	$123.10	$123.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $220.80 / $259.70 / $259.70	Professional	TC	$220.80	$259.70	$259.70