Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $478.63 / $812.83	Professional		$295.12	$478.63	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $144.54 / $354.81	Professional	26	$77.62	$144.54	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $338.84 / $616.60	Professional	TC	$269.15	$338.84	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $758.58 / $954.99	Professional		$616.60	$758.58	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $177.83 / $223.87	Professional	26	$144.54	$177.83	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $588.84 / $724.44	Professional	TC	$467.74	$588.84	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $645.65 / $1,096.48	Professional		$323.59	$645.65	$1,096.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $138.04 / $229.09	Professional	26	$81.28	$138.04	$229.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $512.86 / $2,951.21	Professional	TC	$302.00	$512.86	$2,951.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $676.08 / $831.76	Professional		$630.96	$676.08	$831.76
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $162.18 / $190.55	Professional	26	$154.88	$162.18	$190.55
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $512.86 / $645.65	Professional	TC	$478.63	$512.86	$645.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	26	$169.82	$169.82	$169.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $588.84 / $588.84	Professional	TC	$588.84	$588.84	$588.84
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $616.60 / $758.58	Professional		$416.87	$616.60	$758.58
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $128.82 / $147.91	Professional	26	$95.50	$128.82	$147.91
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $467.74 / $660.69	Professional	TC	$316.23	$467.74	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $660.69 / $891.25	Professional		$389.05	$660.69	$891.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $138.04 / $199.53	Professional	26	$81.28	$138.04	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $537.03 / $691.83	Professional	TC	$295.12	$537.03	$691.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $831.76 / $831.76	Professional		$707.95	$831.76	$831.76
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 $537.03 / $630.96 / $630.96	Professional	TC	$537.03	$630.96	$630.96