Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $478.63 / $2,951.21	Professional		$234.42	$478.63	$2,951.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $234.42 / $354.81	Professional	26	$97.72	$234.42	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $407.38 / $1,659.59	Professional	TC	$302.00	$407.38	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $933.25 / $1,174.90	Professional		$741.31	$933.25	$1,174.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $239.88 / $295.12	Professional	26	$190.55	$239.88	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $562.34 / $691.83 / $870.96	Professional	TC	$562.34	$691.83	$870.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $812.83 / $1,348.96	Professional		$398.11	$812.83	$1,348.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $302.00	Professional	26	$107.15	$181.97	$302.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $630.96 / $5,495.41	Professional	TC	$363.08	$630.96	$5,495.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $831.76 / $1,023.29	Professional		$776.25	$831.76	$1,023.29
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $218.78 / $251.19	Professional	26	$204.17	$218.78	$251.19
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $616.60 / $776.25	Professional	TC	$575.44	$616.60	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Professional		$933.25	$933.25	$933.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	26	$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $707.95 / $707.95	Professional	TC	$707.95	$707.95	$707.95
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $758.58 / $933.25	Professional		$512.86	$758.58	$933.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $165.96 / $199.53	Professional	26	$125.89	$165.96	$199.53
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $562.34 / $812.83	Professional	TC	$389.05	$562.34	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $812.83 / $1,096.48	Professional		$478.63	$812.83	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $263.03	Professional	26	$107.15	$181.97	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $645.65 / $870.96	Professional	TC	$354.81	$645.65	$870.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,023.29 / $1,023.29	Professional		$870.96	$1,023.29	$1,023.29
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $269.15 / $269.15	Professional	26	$229.09	$269.15	$269.15
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $758.58 / $758.58	Professional	TC	$645.65	$758.58	$758.58