Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.57 / $83.57 / $83.57	Facility	26	$83.57	$83.57	$83.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $283.45 / $366.15 / $522.50	Professional		$283.45	$366.15	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.41 / $90.24 / $154.00	Professional	26	$72.41	$90.24	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $211.05 / $268.13 / $368.50	Professional	TC	$211.05	$268.13	$368.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $589.33 / $720.63 / $900.78	Professional		$589.33	$720.63	$900.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $151.62 / $185.39 / $231.74	Professional	26	$151.62	$185.39	$231.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $437.72 / $535.23 / $669.04	Professional	TC	$437.72	$535.23	$669.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $425.74 / $656.34 / $3,392.38	Professional		$425.74	$656.34	$3,392.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.08 / $160.44 / $667.05	Professional	26	$104.08	$160.44	$667.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $321.66 / $495.89 / $2,981.99	Professional	TC	$321.66	$495.89	$2,981.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $272.02 / $272.02 / $272.02	Facility	26	$272.02	$272.02	$272.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $653.97 / $797.35 / $1,059.00	Professional		$653.97	$797.35	$1,059.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $437.23 / $582.98 / $752.12	Professional		$437.23	$582.98	$752.12
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $105.97 / $137.88 / $157.19	Professional	26	$105.97	$137.88	$157.19
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $326.02 / $437.30 / $606.41	Professional	TC	$326.02	$437.30	$606.41
United Facility/Professional Professional Modifier Low / Median / High Price $372.68 / $656.34 / $915.70	Professional		$372.68	$656.34	$915.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.67 / $160.44 / $185.53	Professional	26	$96.67	$160.44	$185.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $276.01 / $495.89 / $742.04	Professional	TC	$276.01	$495.89	$742.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $684.10 / $804.90 / $804.90	Professional		$684.10	$804.90	$804.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $180.90 / $212.80 / $212.80	Professional	26	$180.90	$212.80	$212.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $503.20 / $592.00 / $592.00	Professional	TC	$503.20	$592.00	$592.00