Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.72 / $124.72 / $124.72	Facility	26	$124.72	$124.72	$124.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.65 / $475.00 / $612.66	Professional		$340.65	$475.00	$612.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.72 / $253.40 / $543.79	Professional	26	$124.72	$253.40	$543.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $232.18 / $335.00 / $423.91	Professional	TC	$232.18	$335.00	$423.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $702.25 / $858.70 / $1,073.36	Professional		$702.25	$858.70	$1,073.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $227.11 / $277.70 / $347.13	Professional	26	$227.11	$277.70	$347.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $475.15 / $581.00 / $726.25	Professional	TC	$475.15	$581.00	$726.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $508.88 / $784.53 / $3,919.13	Professional		$508.88	$784.53	$3,919.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $153.88 / $237.23 / $771.93	Professional	26	$153.88	$237.23	$771.93
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $355.00 / $547.29 / $3,292.02	Professional	TC	$355.00	$547.29	$3,292.02
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $411.71 / $411.71 / $411.71	Facility	26	$411.71	$411.71	$411.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $780.65 / $953.12 / $1,241.94	Professional		$780.65	$953.12	$1,241.94
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $510.58 / $674.22 / $721.56	Professional		$510.58	$674.22	$721.56
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $157.03 / $206.53 / $235.47	Professional	26	$157.03	$206.53	$235.47
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $353.53 / $450.50 / $502.09	Professional	TC	$353.53	$450.50	$502.09
United Facility/Professional Professional Modifier Low / Median / High Price $447.78 / $784.53 / $930.24	Professional		$447.78	$784.53	$930.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $144.19 / $230.82 / $274.80	Professional	26	$144.19	$230.82	$274.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $303.58 / $547.03 / $628.38	Professional	TC	$303.58	$547.03	$628.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $816.60 / $960.80 / $960.80	Professional		$816.60	$960.80	$960.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $271.00 / $318.80 / $318.80	Professional	26	$271.00	$318.80	$318.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $545.70 / $642.00 / $642.00	Professional	TC	$545.70	$642.00	$642.00