Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $426.58 / $1,698.24	Professional		$190.55	$426.58	$1,698.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $125.89 / $331.13	Professional	26	$66.07	$125.89	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $208.93 / $426.58	Professional	TC	$125.89	$208.93	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $588.84	Professional		$380.19	$478.63	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $158.49 / $199.53	Professional	26	$128.82	$158.49	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $316.23 / $398.11	Professional	TC	$251.19	$316.23	$398.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $467.74 / $954.99	Professional		$269.15	$467.74	$954.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $204.17	Professional	26	$74.13	$125.89	$204.17
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $346.74 / $2,454.71	Professional	TC	$186.21	$346.74	$2,454.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $426.58 / $549.54	Professional		$398.11	$426.58	$549.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $144.54 / $169.82	Professional	26	$138.04	$144.54	$169.82
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $275.42 / $371.54	Professional	TC	$257.04	$275.42	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	26	$151.36	$151.36	$151.36
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $309.03 / $309.03	Professional	TC	$309.03	$309.03	$309.03
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $660.69	Professional		$263.03	$389.05	$660.69
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $112.20 / $131.83	Professional	26	$85.11	$112.20	$131.83
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $251.19 / $562.34	Professional	TC	$181.97	$251.19	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $446.68 / $724.44	Professional		$239.88	$446.68	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $123.03 / $177.83	Professional	26	$74.13	$123.03	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $338.84 / $575.44	Professional	TC	$158.49	$338.84	$575.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $524.81 / $524.81	Professional		$446.68	$524.81	$524.81
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $177.83 / $177.83	Professional	26	$151.36	$177.83	$177.83
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $338.84 / $338.84	Professional	TC	$288.40	$338.84	$338.84