Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Facility	26	$83.18	$83.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $851.14	Professional		$295.12	$426.58	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $114.82 / $199.53	Professional	26	$77.62	$114.82	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $316.23 / $562.34	Professional	TC	$218.78	$316.23	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $741.31 / $912.01	Professional		$588.84	$741.31	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $190.55 / $234.42	Professional	26	$151.36	$190.55	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $549.54 / $691.83	Professional	TC	$436.52	$549.54	$691.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $691.83 / $1,288.25	Professional		$389.05	$691.83	$1,288.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $147.91 / $660.69	Professional	26	$87.10	$147.91	$660.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $562.34 / $2,951.21	Professional	TC	$316.23	$562.34	$2,951.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $660.69 / $794.33	Professional		$602.56	$660.69	$794.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $173.78 / $199.53	Professional	26	$162.18	$173.78	$199.53
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $478.63 / $602.56	Professional	TC	$446.68	$478.63	$602.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Professional		$724.44	$724.44	$724.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Professional	26	$177.83	$177.83	$177.83
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $537.03 / $537.03	Professional	TC	$537.03	$537.03	$537.03
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $912.01	Professional		$416.87	$588.84	$912.01
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $134.90 / $158.49	Professional	26	$102.33	$134.90	$158.49
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $436.52 / $794.33	Professional	TC	$309.03	$436.52	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $676.08 / $1,000.00	Professional		$371.54	$676.08	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $147.91 / $208.93	Professional	26	$87.10	$147.91	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $512.86 / $812.83	Professional	TC	$275.42	$512.86	$812.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $812.83 / $812.83	Professional		$691.83	$812.83	$812.83
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $213.80 / $213.80	Professional	26	$181.97	$213.80	$213.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $588.84 / $588.84	Professional	TC	$501.19	$588.84	$588.84