Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.45 / $67.45 / $67.45	Facility	26	$67.45	$67.45	$67.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.16 / $410.67 / $587.44	Professional		$222.16	$410.67	$587.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.20 / $67.45 / $226.95	Professional	26	$62.20	$67.45	$226.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.46 / $346.55 / $502.82	Professional	TC	$163.46	$346.55	$502.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $506.87 / $619.78 / $774.73	Professional		$506.87	$619.78	$774.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.43 / $149.71 / $187.14	Professional	26	$122.43	$149.71	$187.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $384.43 / $470.07 / $587.59	Professional	TC	$384.43	$470.07	$587.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.77 / $519.89 / $2,385.40	Professional		$316.77	$519.89	$2,385.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.99 / $129.47 / $533.30	Professional	26	$83.99	$129.47	$533.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $232.73 / $387.88 / $2,603.00	Professional	TC	$232.73	$387.88	$2,603.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $224.51 / $224.51 / $224.51	Facility	26	$224.51	$224.51	$224.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $503.61 / $599.40 / $747.01	Professional		$503.61	$599.40	$747.01
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $319.13 / $433.87 / $520.42	Professional		$319.13	$433.87	$520.42
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $85.38 / $111.21 / $126.79	Professional	26	$85.38	$111.21	$126.79
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $232.99 / $326.08 / $395.55	Professional	TC	$232.99	$326.08	$395.55
United Facility/Professional Professional Modifier Low / Median / High Price $322.36 / $505.84 / $571.65	Professional		$322.36	$505.84	$571.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.29 / $125.99 / $149.72	Professional	26	$78.29	$125.99	$149.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.07 / $390.41 / $407.27	Professional	TC	$244.07	$390.41	$407.27
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $506.30 / $595.70 / $595.70	Professional		$506.30	$595.70	$595.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $125.80 / $148.00 / $148.00	Professional	26	$125.80	$148.00	$148.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $380.60 / $447.70 / $447.70	Professional	TC	$380.60	$447.70	$447.70