Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.04 / $84.04 / $84.04	Facility	26	$84.04	$84.04	$84.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.29 / $294.05 / $386.70	Professional		$212.29	$294.05	$386.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.90 / $77.15 / $126.73	Professional	26	$72.90	$77.15	$126.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.38 / $216.88 / $259.95	Professional	TC	$139.38	$216.88	$259.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $444.06 / $542.99 / $678.74	Professional		$444.06	$542.99	$678.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $152.88 / $186.94 / $233.68	Professional	26	$152.88	$186.94	$233.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $291.18 / $356.05 / $445.06	Professional	TC	$291.18	$356.05	$445.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $300.85 / $463.81 / $1,515.48	Professional		$300.85	$463.81	$1,515.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.03 / $160.88 / $521.79	Professional	26	$104.03	$160.88	$521.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $196.50 / $302.93 / $993.68	Professional	TC	$196.50	$302.93	$993.68
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $269.45 / $269.45 / $269.45	Facility	26	$269.45	$269.45	$269.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $493.86 / $575.96 / $638.92	Professional		$493.86	$575.96	$638.92
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $325.20 / $426.53 / $470.74	Professional		$325.20	$426.53	$470.74
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $105.97 / $141.11 / $157.84	Professional	26	$105.97	$141.11	$157.84
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $217.04 / $276.57 / $325.02	Professional	TC	$217.04	$276.57	$325.02
United Facility/Professional Professional Modifier Low / Median / High Price $279.61 / $451.28 / $570.16	Professional		$279.61	$451.28	$570.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.07 / $156.53 / $186.17	Professional	26	$97.07	$156.53	$186.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $182.54 / $302.93 / $416.62	Professional	TC	$182.54	$302.93	$416.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $445.40 / $524.00 / $524.00	Professional		$445.40	$524.00	$524.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $156.60 / $184.20 / $184.20	Professional	26	$156.60	$184.20	$184.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $288.80 / $339.80 / $339.80	Professional	TC	$288.80	$339.80	$339.80