Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.08 / $116.08 / $116.08	Facility	26	$116.08	$116.08	$116.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.44 / $307.06 / $366.45	Professional		$198.44	$307.06	$366.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.63 / $106.23 / $176.08	Professional	26	$100.63	$106.23	$176.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.81 / $190.35 / $200.83	Professional	TC	$97.81	$190.35	$200.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $641.48 / $980.48 / $1,225.60	Professional		$641.48	$980.48	$1,225.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $211.25 / $258.31 / $322.89	Professional	26	$211.25	$258.31	$322.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $472.48 / $722.18 / $902.72	Professional	TC	$472.48	$722.18	$902.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $522.79 / $891.85 / $1,915.39	Professional		$522.79	$891.85	$1,915.39
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $144.24 / $222.37 / $717.76	Professional	26	$144.24	$222.37	$717.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $434.26 / $669.48 / $1,435.54	Professional	TC	$434.26	$669.48	$1,435.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $370.31 / $370.31 / $370.31	Facility	26	$370.31	$370.31	$370.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $452.03 / $510.10 / $592.86	Professional		$452.03	$510.10	$592.86
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $584.94 / $768.25 / $827.24	Professional		$584.94	$768.25	$827.24
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $147.90 / $196.53 / $219.95	Professional	26	$147.90	$196.53	$219.95
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $435.47 / $559.29 / $612.35	Professional	TC	$435.47	$559.29	$612.35
United Facility/Professional Professional Modifier Low / Median / High Price $509.70 / $867.74 / $980.80	Professional		$509.70	$867.74	$980.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $134.22 / $216.36 / $252.88	Professional	26	$134.22	$216.36	$252.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $375.48 / $651.38 / $737.72	Professional	TC	$375.48	$651.38	$737.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $802.20 / $943.80 / $943.80	Professional		$802.20	$943.80	$943.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $218.20 / $256.70 / $256.70	Professional	26	$218.20	$256.70	$256.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $584.00 / $687.00 / $687.00	Professional	TC	$584.00	$687.00	$687.00