Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $67.61 / $67.61	Facility	26	$48.98	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $331.13 / $707.95	Professional		$213.80	$331.13	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $81.28 / $213.80	Professional	26	$61.66	$81.28	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $229.09 / $416.87	Professional	TC	$162.18	$229.09	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $630.96 / $794.33	Professional		$501.19	$630.96	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $154.88 / $190.55	Professional	26	$123.03	$154.88	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $478.63 / $602.56	Professional	TC	$380.19	$478.63	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $446.68 / $831.76	Professional		$239.88	$446.68	$831.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $194.98	Professional	26	$70.79	$120.23	$194.98
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $346.74 / $2,630.27	Professional	TC	$194.98	$346.74	$2,630.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $524.81 / $602.56	Professional		$478.63	$524.81	$602.56
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $138.04 / $162.18	Professional	26	$131.83	$138.04	$162.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $389.05 / $436.52	Professional	TC	$346.74	$389.05	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	26	$144.54	$144.54	$144.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	TC	$371.54	$371.54	$371.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $446.68 / $645.65	Professional		$331.13	$446.68	$645.65
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $125.89	Professional	26	$81.28	$109.65	$125.89
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $549.54	Professional	TC	$245.47	$338.84	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $478.63 / $660.69	Professional		$288.40	$478.63	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $151.36	Professional	26	$70.79	$120.23	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $380.19 / $489.78	Professional	TC	$218.78	$380.19	$489.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $602.56 / $602.56	Professional		$501.19	$602.56	$602.56
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $147.91 / $147.91	Professional	26	$125.89	$147.91	$147.91
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $446.68 / $446.68	Professional	TC	$380.19	$446.68	$446.68