Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.70 / $65.70 / $65.70	Facility	26	$65.70	$65.70	$65.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.14 / $221.36 / $598.50	Professional		$62.14	$221.36	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.58 / $140.00 / $386.26	Professional	26	$60.58	$140.00	$386.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $94.85 / $94.85 / $110.68	Professional	52	$94.85	$94.85	$110.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $155.66 / $422.10 / $1,934.55	Professional	TC	$155.66	$422.10	$1,934.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $396.48 / $484.81 / $606.02	Professional		$396.48	$484.81	$606.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.26 / $145.83 / $182.29	Professional	26	$119.26	$145.83	$182.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $277.22 / $338.98 / $423.73	Professional	TC	$277.22	$338.98	$423.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $276.70 / $426.59 / $2,791.06	Professional		$276.70	$426.59	$2,791.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.51 / $125.65 / $525.38	Professional	26	$81.51	$125.65	$525.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $195.20 / $300.94 / $2,451.15	Professional	TC	$195.20	$300.94	$2,451.15
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $221.77 / $221.77 / $221.77	Facility	26	$221.77	$221.77	$221.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $440.48 / $518.78 / $871.00	Professional		$440.48	$518.78	$871.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $282.74 / $380.44 / $466.49	Professional		$282.74	$380.44	$466.49
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $82.81 / $108.37 / $123.56	Professional	26	$82.81	$108.37	$123.56
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $199.94 / $263.05 / $329.87	Professional	TC	$199.94	$263.05	$329.87
United Facility/Professional Professional Modifier Low / Median / High Price $249.66 / $426.59 / $534.70	Professional		$249.66	$426.59	$534.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.68 / $122.26 / $145.31	Professional	26	$74.68	$122.26	$145.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.36 / $292.80 / $369.57	Professional	TC	$173.36	$292.80	$369.57
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $460.80 / $542.10 / $542.10	Professional		$460.80	$542.10	$542.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $142.19 / $167.30 / $167.30	Professional	26	$142.19	$167.30	$167.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $318.60 / $374.80 / $374.80	Professional	TC	$318.60	$374.80	$374.80