Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.34 / $65.34 / $65.34	Facility	26	$65.34	$65.34	$65.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.30 / $413.00 / $532.00	Professional		$209.30	$413.00	$532.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.50 / $146.69 / $340.87	Professional	26	$60.50	$146.69	$340.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.74 / $335.00 / $422.10	Professional	TC	$152.74	$335.00	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.91 / $530.58 / $663.22	Professional		$433.91	$530.58	$663.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.63 / $145.06 / $181.32	Professional	26	$118.63	$145.06	$181.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $315.27 / $385.52 / $481.90	Professional	TC	$315.27	$385.52	$481.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $312.05 / $480.67 / $2,789.74	Professional		$312.05	$480.67	$2,789.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.04 / $124.99 / $531.65	Professional	26	$81.04	$124.99	$531.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $231.26 / $384.41 / $2,459.04	Professional	TC	$231.26	$384.41	$2,459.04
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $214.93 / $214.93 / $214.93	Facility	26	$214.93	$214.93	$214.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $481.78 / $583.39 / $871.00	Professional		$481.78	$583.39	$871.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $319.60 / $437.95 / $638.37	Professional		$319.60	$437.95	$638.37
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.95 / $109.25 / $122.91	Professional	26	$81.95	$109.25	$122.91
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $234.88 / $315.04 / $510.70	Professional	TC	$234.88	$315.04	$510.70
United Facility/Professional Professional Modifier Low / Median / High Price $275.22 / $480.67 / $770.95	Professional		$275.22	$480.67	$770.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.48 / $124.99 / $141.81	Professional	26	$75.48	$124.99	$141.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.73 / $355.68 / $599.17	Professional	TC	$199.73	$355.68	$599.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $504.00 / $592.90 / $592.90	Professional		$504.00	$592.90	$592.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $141.40 / $166.40 / $166.40	Professional	26	$141.40	$166.40	$166.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $362.50 / $426.50 / $426.50	Professional	TC	$362.50	$426.50	$426.50