Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	26	$64.57	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $263.03 / $912.01	Professional		$97.72	$263.03	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $125.89 / $389.05	Professional	26	$60.26	$125.89	$389.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $478.63 / $478.63 / $478.63	Professional	50	$478.63	$478.63	$478.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Professional	52	$1,023.29	$1,023.29	$1,023.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $371.54 / $1,949.84	Professional	TC	$154.88	$371.54	$1,949.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $501.19 / $616.60	Professional		$398.11	$501.19	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $147.91 / $186.21	Professional	26	$120.23	$147.91	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $346.74 / $436.52	Professional	TC	$275.42	$346.74	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $407.38 / $912.01	Professional		$204.17	$407.38	$912.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $190.55	Professional	26	$74.13	$125.89	$190.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $295.12 / $2,454.71	Professional	TC	$169.82	$295.12	$2,454.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $436.52 / $512.86	Professional		$407.38	$436.52	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $134.90 / $158.49	Professional	26	$128.82	$134.90	$158.49
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $302.00 / $363.08	Professional	TC	$281.84	$302.00	$363.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $331.13 / $331.13	Professional	TC	$331.13	$331.13	$331.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $724.44	Professional		$263.03	$389.05	$724.44
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $107.15 / $123.03	Professional	26	$79.43	$107.15	$123.03
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $275.42 / $630.96	Professional	TC	$181.97	$275.42	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $575.44	Professional		$251.19	$426.58	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $114.82 / $165.96	Professional	26	$67.61	$114.82	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $302.00 / $426.58	Professional	TC	$173.78	$302.00	$426.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $537.03 / $537.03	Professional		$457.09	$537.03	$537.03
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $165.96 / $165.96	Professional	26	$141.25	$165.96	$165.96
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $371.54 / $371.54	Professional	TC	$316.23	$371.54	$371.54