Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.28 / $84.28 / $84.28	Facility	26	$84.28	$84.28	$84.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.33 / $213.75 / $1,352.64	Professional		$170.33	$213.75	$1,352.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.65 / $83.39 / $295.20	Professional	26	$77.65	$83.39	$295.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.31 / $150.21 / $3,779.10	Professional	TC	$97.31	$150.21	$3,779.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $355.88 / $435.17 / $543.96	Professional		$355.88	$435.17	$543.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $152.88 / $186.94 / $233.68	Professional	26	$152.88	$186.94	$233.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.00 / $248.22 / $310.27	Professional	TC	$203.00	$248.22	$310.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $241.08 / $371.67 / $1,217.23	Professional		$241.08	$371.67	$1,217.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.63 / $161.12 / $396.90	Professional	26	$104.63	$161.12	$396.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $136.57 / $210.55 / $1,308.00	Professional	TC	$136.57	$210.55	$1,308.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $269.43 / $269.43 / $269.43	Facility	26	$269.43	$269.43	$269.43
Midlands Facility/Professional Professional Modifier Low / Median / High Price $388.78 / $449.39 / $516.42	Professional		$388.78	$449.39	$516.42
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $241.13 / $321.45 / $361.62	Professional		$241.13	$321.45	$361.62
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $106.84 / $142.25 / $158.49	Professional	26	$106.84	$142.25	$158.49
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $134.29 / $179.04 / $203.48	Professional	TC	$134.29	$179.04	$203.48
United Facility/Professional Professional Modifier Low / Median / High Price $224.89 / $361.62 / $413.89	Professional		$224.89	$361.62	$413.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.46 / $161.12 / $224.15	Professional	26	$97.46	$161.12	$224.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.43 / $204.86 / $228.54	Professional	TC	$127.43	$204.86	$228.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $358.70 / $422.00 / $422.00	Professional		$358.70	$422.00	$422.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $157.19 / $185.00 / $185.00	Professional	26	$157.19	$185.00	$185.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $201.50 / $237.10 / $237.10	Professional	TC	$201.50	$237.10	$237.10