Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.25 / $115.25 / $115.25	Facility	26	$115.25	$115.25	$115.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.17 / $372.31 / $548.44	Professional		$263.17	$372.31	$548.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.09 / $111.49 / $307.05	Professional	26	$106.09	$111.49	$307.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.97 / $266.22 / $373.84	Professional	TC	$162.97	$266.22	$373.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $628.66 / $768.72 / $960.90	Professional		$628.66	$768.72	$960.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $209.98 / $256.76 / $320.95	Professional	26	$209.98	$256.76	$320.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $403.72 / $511.96 / $639.95	Professional	TC	$403.72	$511.96	$639.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $435.42 / $671.27 / $2,091.94	Professional		$435.42	$671.27	$2,091.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $142.44 / $219.87 / $711.82	Professional	26	$142.44	$219.87	$711.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $292.80 / $451.40 / $1,773.11	Professional	TC	$292.80	$451.40	$1,773.11
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $366.11 / $366.11 / $366.11	Facility	26	$366.11	$366.11	$366.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $612.36 / $711.65 / $903.15	Professional		$612.36	$711.65	$903.15
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $474.58 / $604.77 / $692.54	Professional		$474.58	$604.77	$692.54
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $144.16 / $192.19 / $218.01	Professional	26	$144.16	$192.19	$218.01
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $312.05 / $397.65 / $488.66	Professional	TC	$312.05	$397.65	$488.66
United Facility/Professional Professional Modifier Low / Median / High Price $395.46 / $671.27 / $846.92	Professional		$395.46	$671.27	$846.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $133.41 / $219.87 / $249.27	Professional	26	$133.41	$219.87	$249.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $262.04 / $451.40 / $614.19	Professional	TC	$262.04	$451.40	$614.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $631.50 / $742.90 / $742.90	Professional		$631.50	$742.90	$742.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $216.30 / $254.40 / $254.40	Professional	26	$216.30	$254.40	$254.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $415.20 / $488.50 / $488.50	Professional	TC	$415.20	$488.50	$488.50