Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.51 / $57.51 / $57.51	Facility	26	$57.51	$57.51	$57.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.30 / $249.83 / $274.81	Professional		$127.30	$249.83	$274.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.01 / $59.87 / $265.50	Professional	26	$50.01	$59.87	$265.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.29 / $195.40 / $214.94	Professional	TC	$77.29	$195.40	$214.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.17 / $324.24 / $405.30	Professional		$265.17	$324.24	$405.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.67 / $127.99 / $159.99	Professional	26	$104.67	$127.99	$159.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.50 / $196.25 / $245.32	Professional	TC	$160.50	$196.25	$245.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $179.98 / $277.45 / $1,561.56	Professional		$179.98	$277.45	$1,561.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.39 / $110.30 / $386.35	Professional	26	$71.39	$110.30	$386.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $108.43 / $167.16 / $1,649.00	Professional	TC	$108.43	$167.16	$1,649.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $188.38 / $188.38 / $188.38	Facility	26	$188.38	$188.38	$188.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $288.92 / $334.91 / $494.00	Professional		$288.92	$334.91	$494.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $180.20 / $243.68 / $301.18	Professional		$180.20	$243.68	$301.18
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $72.52 / $94.76 / $108.03	Professional	26	$72.52	$94.76	$108.03
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $107.69 / $145.63 / $184.16	Professional	TC	$107.69	$145.63	$184.16
United Facility/Professional Professional Modifier Low / Median / High Price $167.77 / $277.45 / $308.20	Professional		$167.77	$277.45	$308.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.08 / $107.32 / $124.93	Professional	26	$60.08	$107.32	$124.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.06 / $162.63 / $181.16	Professional	TC	$101.06	$162.63	$181.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $266.30 / $313.30 / $313.30	Professional		$266.30	$313.30	$313.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $107.20 / $126.10 / $126.10	Professional	26	$107.20	$126.10	$126.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $159.19 / $187.20 / $187.20	Professional	TC	$159.19	$187.20	$187.20