Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $85.11	Facility	26	$85.11	$85.11	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $457.09 / $1,905.46	Professional		$323.59	$457.09	$1,905.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $338.84	Professional	26	$81.28	$125.89	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $616.60	Professional	TC	$245.47	$338.84	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $831.76 / $1,023.29	Professional		$660.69	$831.76	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $199.53 / $245.47	Professional	26	$158.49	$199.53	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $630.96 / $776.25	Professional	TC	$501.19	$630.96	$776.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $645.65 / $1,148.15	Professional		$346.74	$645.65	$1,148.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $851.14	Professional	26	$89.13	$151.36	$851.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $537.03 / $2,570.40	Professional	TC	$316.23	$537.03	$2,570.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $724.44 / $870.96	Professional		$676.08	$724.44	$870.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $181.97 / $208.93	Professional	26	$169.82	$181.97	$208.93
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $549.54 / $660.69	Professional	TC	$501.19	$549.54	$660.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	26	$186.21	$186.21	$186.21
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $602.56 / $602.56	Professional	TC	$602.56	$602.56	$602.56
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $660.69 / $812.83	Professional		$436.52	$660.69	$812.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $141.25 / $165.96	Professional	26	$104.71	$141.25	$165.96
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $501.19 / $691.83	Professional	TC	$331.13	$501.19	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $707.95 / $954.99	Professional		$416.87	$707.95	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $151.36 / $218.78	Professional	26	$91.20	$151.36	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $537.03 / $724.44	Professional	TC	$316.23	$537.03	$724.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $891.25 / $891.25	Professional		$758.58	$891.25	$891.25
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $223.87 / $223.87	Professional	26	$190.55	$223.87	$223.87
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $676.08 / $676.08	Professional	TC	$575.44	$676.08	$676.08