Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.04 / $104.04 / $104.04	Facility	26	$104.04	$104.04	$104.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.65 / $371.24 / $598.50	Professional		$100.65	$371.24	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.93 / $234.07 / $278.57	Professional	26	$97.93	$234.07	$278.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.75 / $335.00 / $422.10	Professional	TC	$225.75	$335.00	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $656.58 / $802.85 / $1,003.56	Professional		$656.58	$802.85	$1,003.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $189.68 / $231.93 / $289.92	Professional	26	$189.68	$231.93	$289.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $466.90 / $570.91 / $713.64	Professional	TC	$466.90	$570.91	$713.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $472.50 / $728.44 / $5,978.92	Professional		$472.50	$728.44	$5,978.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $128.76 / $198.51 / $733.09	Professional	26	$128.76	$198.51	$733.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $343.74 / $529.92 / $5,438.76	Professional	TC	$343.74	$529.92	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $336.47 / $336.47 / $336.47	Facility	26	$336.47	$336.47	$336.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $729.41 / $885.56 / $1,437.58	Professional		$729.41	$885.56	$1,437.58
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $484.80 / $629.97 / $831.17	Professional		$484.80	$629.97	$831.17
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $125.41 / $173.06 / $197.30	Professional	26	$125.41	$173.06	$197.30
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $347.26 / $465.77 / $650.07	Professional	TC	$347.26	$465.77	$650.07
United Facility/Professional Professional Modifier Low / Median / High Price $415.43 / $728.44 / $1,011.72	Professional		$415.43	$728.44	$1,011.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.24 / $198.51 / $261.02	Professional	26	$120.24	$198.51	$261.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.19 / $529.92 / $796.58	Professional	TC	$295.19	$529.92	$796.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $763.00 / $897.70 / $897.70	Professional		$763.00	$897.70	$897.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $227.10 / $267.10 / $267.10	Professional	26	$227.10	$267.10	$267.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $536.00 / $630.60 / $630.60	Professional	TC	$536.00	$630.60	$630.60