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 / $426.37 / $598.50	Professional		$100.65	$426.37	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.66 / $233.10 / $281.24	Professional	26	$96.66	$233.10	$281.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $271.38 / $335.00 / $462.42	Professional	TC	$271.38	$335.00	$462.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.56 / $915.33 / $1,144.16	Professional		$748.56	$915.33	$1,144.16
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 $558.88 / $683.39 / $854.24	Professional	TC	$558.88	$683.39	$854.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $547.00 / $843.29 / $5,981.06	Professional		$547.00	$843.29	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $129.08 / $199.18 / $883.52	Professional	26	$129.08	$199.18	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $417.80 / $644.11 / $5,438.76	Professional	TC	$417.80	$644.11	$5,438.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $340.60 / $340.60 / $340.60	Facility	26	$340.60	$340.60	$340.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $830.46 / $1,022.32 / $1,436.46	Professional		$830.46	$1,022.32	$1,436.46
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $554.22 / $717.24 / $866.61	Professional		$554.22	$717.24	$866.61
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $131.72 / $173.06 / $197.30	Professional	26	$131.72	$173.06	$197.30
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $415.32 / $529.79 / $676.27	Professional	TC	$415.32	$529.79	$676.27
United Facility/Professional Professional Modifier Low / Median / High Price $475.34 / $820.49 / $994.48	Professional		$475.34	$820.49	$994.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $118.33 / $193.79 / $261.85	Professional	26	$118.33	$193.79	$261.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $354.70 / $626.70 / $791.10	Professional	TC	$354.70	$626.70	$791.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $868.70 / $1,022.10 / $1,022.10	Professional		$868.70	$1,022.10	$1,022.10
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 $641.70 / $754.90 / $754.90	Professional	TC	$641.70	$754.90	$754.90