Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.54 / $105.54 / $105.54	Facility	26	$105.54	$105.54	$105.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.58 / $541.83 / $782.00	Professional		$355.58	$541.83	$782.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.92 / $160.18 / $380.70	Professional	26	$93.92	$160.18	$380.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.83 / $447.91 / $657.20	Professional	TC	$263.83	$447.91	$657.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $740.95 / $906.02 / $1,132.52	Professional		$740.95	$906.02	$1,132.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $192.22 / $235.04 / $293.80	Professional	26	$192.22	$235.04	$293.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $548.73 / $670.98 / $838.73	Professional	TC	$548.73	$670.98	$838.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $468.96 / $755.23 / $2,573.48	Professional		$468.96	$755.23	$2,573.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $131.25 / $202.34 / $653.20	Professional	26	$131.25	$202.34	$653.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $337.55 / $552.89 / $2,038.19	Professional	TC	$337.55	$552.89	$2,038.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $339.72 / $339.72 / $339.72	Facility	26	$339.72	$339.72	$339.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $715.46 / $881.52 / $1,078.49	Professional		$715.46	$881.52	$1,078.49
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $468.10 / $636.23 / $751.81	Professional		$468.10	$636.23	$751.81
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $134.11 / $178.82 / $200.54	Professional	26	$134.11	$178.82	$200.54
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $338.08 / $465.77 / $550.02	Professional	TC	$338.08	$465.77	$550.02
United Facility/Professional Professional Modifier Low / Median / High Price $467.76 / $755.23 / $870.00	Professional		$467.76	$755.23	$870.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.63 / $202.34 / $234.10	Professional	26	$122.63	$202.34	$234.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $345.13 / $552.89 / $614.36	Professional	TC	$345.13	$552.89	$614.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $742.50 / $873.50 / $873.50	Professional		$742.50	$873.50	$873.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $198.90 / $234.10 / $234.10	Professional	26	$198.90	$234.10	$234.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $543.60 / $639.50 / $639.50	Professional	TC	$543.60	$639.50	$639.50