Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.37 / $86.37 / $86.37	Facility	26	$86.37	$86.37	$86.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $315.73 / $475.00 / $630.00	Professional		$315.73	$475.00	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.86 / $136.91 / $189.00	Professional	26	$74.86	$136.91	$189.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.87 / $315.36 / $422.10	Professional	TC	$240.87	$315.36	$422.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $657.21 / $803.63 / $1,004.53	Professional		$657.21	$803.63	$1,004.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $156.69 / $191.60 / $239.50	Professional	26	$156.69	$191.60	$239.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $500.52 / $612.03 / $765.03	Professional	TC	$500.52	$612.03	$765.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $469.20 / $723.35 / $3,007.15	Professional		$469.20	$723.35	$3,007.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.10 / $165.11 / $848.54	Professional	26	$107.10	$165.11	$848.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $362.10 / $558.24 / $2,544.17	Professional	TC	$362.10	$558.24	$2,544.17
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $282.98 / $282.98 / $282.98	Facility	26	$282.98	$282.98	$282.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $729.41 / $877.60 / $1,073.68	Professional		$729.41	$877.60	$1,073.68
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $481.34 / $629.97 / $684.28	Professional		$481.34	$629.97	$684.28
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $109.40 / $142.97 / $163.02	Professional	26	$109.40	$142.97	$163.02
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $366.43 / $475.09 / $547.58	Professional	TC	$366.43	$475.09	$547.58
United Facility/Professional Professional Modifier Low / Median / High Price $415.03 / $703.80 / $852.20	Professional		$415.03	$703.80	$852.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.86 / $165.11 / $191.10	Professional	26	$99.86	$165.11	$191.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $315.17 / $543.15 / $664.59	Professional	TC	$315.17	$543.15	$664.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $763.00 / $897.70 / $897.70	Professional		$763.00	$897.70	$897.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $187.60 / $220.70 / $220.70	Professional	26	$187.60	$220.70	$220.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $575.40 / $677.00 / $677.00	Professional	TC	$575.40	$677.00	$677.00