Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $89.13 / $89.13	Facility	26	$66.07	$89.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $331.13 / $691.83	Professional		$234.42	$331.13	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $107.15 / $302.00	Professional	26	$85.11	$107.15	$302.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $173.78 / $173.78	Professional	50	$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $426.58	Professional	TC	$162.18	$218.78	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $794.33 / $977.24	Professional		$602.56	$794.33	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $208.93 / $257.04	Professional	26	$165.96	$208.93	$257.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $575.44 / $724.44	Professional	TC	$407.38	$575.44	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $575.44 / $1,023.29	Professional		$309.03	$575.44	$1,023.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $162.18 / $562.34	Professional	26	$95.50	$162.18	$562.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $446.68 / $2,398.83	Professional	TC	$263.03	$446.68	$2,398.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $575.44 / $660.69	Professional		$524.81	$575.44	$660.69
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $190.55 / $218.78	Professional	26	$177.83	$190.55	$218.78
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $389.05 / $436.52	Professional	TC	$346.74	$389.05	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $194.98 / $194.98	Professional	26	$194.98	$194.98	$194.98
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	TC	$371.54	$371.54	$371.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $676.08	Professional		$398.11	$575.44	$676.08
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $147.91 / $173.78	Professional	26	$109.65	$147.91	$173.78
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $426.58 / $549.54	Professional	TC	$288.40	$426.58	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $602.56 / $891.25	Professional		$389.05	$602.56	$891.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $162.18 / $204.17	Professional	26	$95.50	$162.18	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $467.74 / $660.69	Professional	TC	$288.40	$467.74	$660.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $741.31 / $741.31	Professional		$630.96	$741.31	$741.31
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $199.53 / $199.53	Professional	26	$169.82	$199.53	$199.53
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $537.03 / $537.03	Professional	TC	$457.09	$537.03	$537.03