Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.56 / $58.56 / $58.56	Facility	26	$58.56	$58.56	$58.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.28 / $333.40 / $563.50	Professional		$135.28	$333.40	$563.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.93 / $58.56 / $135.28	Professional	26	$50.93	$58.56	$135.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.61 / $245.14 / $489.53	Professional	TC	$131.61	$245.14	$489.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.26 / $466.20 / $582.74	Professional		$381.26	$466.20	$582.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.58 / $130.32 / $162.90	Professional	26	$106.58	$130.32	$162.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $274.68 / $335.88 / $419.85	Professional	TC	$274.68	$335.88	$419.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $282.18 / $435.03 / $2,082.64	Professional		$282.18	$435.03	$2,082.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.84 / $112.32 / $381.41	Professional	26	$72.84	$112.32	$381.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $209.33 / $322.70 / $1,754.89	Professional	TC	$209.33	$322.70	$1,754.89
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $193.17 / $193.17 / $193.17	Facility	26	$193.17	$193.17	$193.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $422.71 / $578.20 / $640.00	Professional		$422.71	$578.20	$640.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $286.49 / $384.26 / $451.27	Professional		$286.49	$384.26	$451.27
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.37 / $96.46 / $109.97	Professional	26	$73.37	$96.46	$109.97
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $204.50 / $274.29 / $350.40	Professional	TC	$204.50	$274.29	$350.40
United Facility/Professional Professional Modifier Low / Median / High Price $240.07 / $435.03 / $558.79	Professional		$240.07	$435.03	$558.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $112.32 / $129.93	Professional	26	$67.91	$112.32	$129.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.16 / $322.70 / $429.50	Professional	TC	$172.16	$322.70	$429.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $381.20 / $448.50 / $448.50	Professional		$381.20	$448.50	$448.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $109.10 / $128.30 / $128.30	Professional	26	$109.10	$128.30	$128.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $272.10 / $320.10 / $320.10	Professional	TC	$272.10	$320.10	$320.10