Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.43 / $87.43 / $87.43	Facility	26	$87.43	$87.43	$87.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.05 / $438.48 / $624.64	Professional		$239.05	$438.48	$624.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.89 / $87.34 / $235.85	Professional	26	$75.89	$87.34	$235.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.16 / $351.12 / $509.48	Professional	TC	$163.16	$351.12	$509.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $573.57 / $729.16 / $911.45	Professional		$573.57	$729.16	$911.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $159.22 / $194.70 / $243.38	Professional	26	$159.22	$194.70	$243.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $391.39 / $534.46 / $668.07	Professional	TC	$391.39	$534.46	$668.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $370.26 / $602.92 / $3,101.53	Professional		$370.26	$602.92	$3,101.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $108.50 / $167.80 / $660.44	Professional	26	$108.50	$167.80	$660.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $261.76 / $435.13 / $2,625.91	Professional	TC	$261.76	$435.13	$2,625.91
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $302.50 / $302.50 / $302.50	Facility	26	$302.50	$302.50	$302.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $555.50 / $646.45 / $869.52	Professional		$555.50	$646.45	$869.52
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $373.39 / $511.96 / $606.01	Professional		$373.39	$511.96	$606.01
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $110.70 / $145.25 / $165.61	Professional	26	$110.70	$145.25	$165.61
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $262.27 / $371.18 / $443.73	Professional	TC	$262.27	$371.18	$443.73
United Facility/Professional Professional Modifier Low / Median / High Price $375.89 / $580.92 / $647.96	Professional		$375.89	$580.92	$647.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $101.46 / $167.80 / $233.11	Professional	26	$101.46	$167.80	$233.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.43 / $435.13 / $470.29	Professional	TC	$274.43	$435.13	$470.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $597.50 / $702.90 / $702.90	Professional		$597.50	$702.90	$702.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $164.30 / $193.30 / $193.30	Professional	26	$164.30	$193.30	$193.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $433.20 / $509.60 / $509.60	Professional	TC	$433.20	$509.60	$509.60