Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.90 / $96.90 / $96.90	Facility	26	$96.90	$96.90	$96.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.48 / $434.02 / $636.13	Professional		$318.48	$434.02	$636.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.54 / $95.56 / $336.42	Professional	26	$89.54	$95.56	$336.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.32 / $378.88 / $4,539.00	Professional	TC	$234.32	$378.88	$4,539.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $659.75 / $806.73 / $1,008.41	Professional		$659.75	$806.73	$1,008.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $176.36 / $215.64 / $269.56	Professional	26	$176.36	$215.64	$269.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $483.39 / $591.08 / $738.85	Professional	TC	$483.39	$591.08	$738.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $426.42 / $686.39 / $2,326.86	Professional		$426.42	$686.39	$2,326.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $120.53 / $185.82 / $600.70	Professional	26	$120.53	$185.82	$600.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $305.69 / $500.57 / $2,909.00	Professional	TC	$305.69	$500.57	$2,909.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $310.95 / $310.95 / $310.95	Facility	26	$310.95	$310.95	$310.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $678.75 / $802.15 / $969.20	Professional		$678.75	$802.15	$969.20
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $424.33 / $573.82 / $675.74	Professional		$424.33	$573.82	$675.74
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $123.14 / $163.96 / $183.07	Professional	26	$123.14	$163.96	$183.07
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $301.38 / $410.23 / $496.34	Professional	TC	$301.38	$410.23	$496.34
United Facility/Professional Professional Modifier Low / Median / High Price $418.62 / $667.84 / $755.99	Professional		$418.62	$667.84	$755.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.25 / $180.80 / $214.99	Professional	26	$112.25	$180.80	$214.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $306.37 / $487.04 / $534.95	Professional	TC	$306.37	$487.04	$534.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $660.40 / $776.90 / $776.90	Professional		$660.40	$776.90	$776.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $181.60 / $213.70 / $213.70	Professional	26	$181.60	$213.70	$213.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $478.70 / $563.20 / $563.20	Professional	TC	$478.70	$563.20	$563.20