Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	26	$123.03	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $501.19 / $2,511.89	Professional		$398.11	$501.19	$2,511.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $275.42 / $549.54	Professional	26	$123.03	$275.42	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $630.96	Professional	TC	$245.47	$338.84	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $870.96 / $1,096.48	Professional		$707.95	$870.96	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $281.84 / $354.81	Professional	26	$229.09	$281.84	$354.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $588.84 / $741.31	Professional	TC	$478.63	$588.84	$741.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $724.44 / $1,096.48	Professional		$363.08	$724.44	$1,096.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $204.17 / $363.08	Professional	26	$128.82	$204.17	$363.08
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $512.86 / $851.14	Professional	TC	$302.00	$512.86	$851.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $776.25 / $954.99	Professional		$724.44	$776.25	$954.99
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $257.04 / $295.12	Professional	26	$245.47	$257.04	$295.12
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $524.81 / $660.69	Professional	TC	$489.78	$524.81	$660.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Professional		$870.96	$870.96	$870.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Professional	26	$263.03	$263.03	$263.03
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $602.56 / $602.56	Professional	TC	$602.56	$602.56	$602.56
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $707.95 / $812.83	Professional		$478.63	$707.95	$812.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $204.17 / $234.42	Professional	26	$151.36	$204.17	$234.42
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $478.63 / $724.44	Professional	TC	$331.13	$478.63	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $758.58 / $1,023.29	Professional		$446.68	$758.58	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $218.78 / $309.03	Professional	26	$138.04	$218.78	$309.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $549.54 / $691.83	Professional	TC	$302.00	$549.54	$691.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $954.99 / $954.99	Professional		$812.83	$954.99	$954.99
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $316.23 / $316.23	Professional	26	$269.15	$316.23	$316.23
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $549.54 / $645.65 / $645.65	Professional	TC	$549.54	$645.65	$645.65