Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.09 / $153.09 / $4,945.75	Facility		$153.09	$153.09	$4,945.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.95 / $79.95 / $79.95	Facility	26	$79.95	$79.95	$79.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.63 / $235.93 / $335.62	Professional		$131.63	$235.93	$335.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.81 / $69.30 / $300.60	Professional	26	$51.81	$69.30	$300.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $65.81 / $65.81 / $76.55	Professional	52	$65.81	$65.81	$76.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.33 / $184.12 / $267.08	Professional	TC	$62.33	$184.12	$267.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.68 / $335.88 / $419.85	Professional		$274.68	$335.88	$419.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.94 / $176.86 / $221.07	Professional	26	$124.94	$176.86	$221.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.05 / $159.02 / $198.77	Professional	TC	$130.05	$159.02	$198.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $188.53 / $237.66 / $705.78	Facility		$188.53	$237.66	$705.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $193.33 / $299.42 / $3,102.49	Professional		$193.33	$299.42	$3,102.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.52 / $114.66 / $551.37	Professional	26	$65.52	$114.66	$551.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.14 / $145.13 / $2,808.09	Professional	TC	$94.14	$145.13	$2,808.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $292.27 / $349.86 / $502.67	Facility		$292.27	$349.86	$502.67
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $177.22 / $177.22 / $177.22	Facility	26	$177.22	$177.22	$177.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $309.14 / $371.46 / $640.64	Professional		$309.14	$371.46	$640.64
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $194.36 / $262.83 / $287.22	Professional		$194.36	$262.83	$287.22
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.20 / $116.72 / $156.55	Professional	26	$73.20	$116.72	$156.55
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.42 / $130.66 / $190.81	Professional	TC	$97.42	$130.66	$190.81
United Facility/Professional Professional Modifier Low / Median / High Price $179.75 / $243.82 / $322.22	Professional		$179.75	$243.82	$322.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.56 / $114.66 / $154.29	Professional	26	$86.56	$114.66	$154.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.68 / $138.61 / $223.67	Professional	TC	$82.68	$138.61	$223.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $253.50 / $298.20 / $298.20	Professional		$253.50	$298.20	$298.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $138.19 / $162.60 / $162.60	Professional	26	$138.19	$162.60	$162.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $115.30 / $135.69 / $135.69	Professional	TC	$115.30	$135.69	$135.69