Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $4,897.79 / $7,079.46	Facility		$151.36	$4,897.79	$7,079.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Facility	26	$79.43	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $346.74	Professional		$131.83	$173.78	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $83.18 / $302.00	Professional	26	$57.54	$83.18	$302.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	52	$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $85.11 / $208.93	Professional	TC	$61.66	$85.11	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $426.58	Professional		$275.42	$346.74	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $181.97 / $223.87	Professional	26	$144.54	$181.97	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $162.18 / $204.17	Professional	TC	$128.82	$162.18	$204.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $223.87 / $794.33	Facility		$158.49	$223.87	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $245.47 / $457.09	Professional		$141.25	$245.47	$457.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $107.15 / $549.54	Professional	26	$60.26	$107.15	$549.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $144.54 / $2,818.38	Professional	TC	$91.20	$144.54	$2,818.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $316.23 / $371.54	Professional		$295.12	$316.23	$371.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $173.78 / $194.98	Professional	26	$158.49	$173.78	$194.98
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $144.54 / $177.83	Professional	TC	$131.83	$144.54	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Professional	26	$177.83	$177.83	$177.83
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	TC	$158.49	$158.49	$158.49
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $263.03 / $302.00	Professional		$186.21	$263.03	$302.00
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $112.20 / $154.88	Professional	26	$74.13	$112.20	$154.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $131.83 / $190.55	Professional	TC	$89.13	$131.83	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $275.42 / $407.38	Professional		$177.83	$275.42	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $107.15 / $154.88	Professional	26	$60.26	$107.15	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $147.91 / $269.15	Professional	TC	$83.18	$147.91	$269.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $295.12 / $295.12	Professional		$251.19	$295.12	$295.12
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $162.18 / $162.18	Professional	26	$138.04	$162.18	$162.18
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $134.90 / $134.90	Professional	TC	$114.82	$134.90	$134.90