Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.24 / $90.24 / $90.24	Facility	26	$90.24	$90.24	$90.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.52 / $272.08 / $386.25	Professional		$143.52	$272.08	$386.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.42 / $78.45 / $138.49	Professional	26	$60.42	$78.45	$138.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.06 / $211.66 / $306.81	Professional	TC	$65.06	$211.66	$306.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.60 / $370.01 / $462.51	Professional		$302.60	$370.01	$462.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.52 / $200.91 / $251.13	Professional	26	$144.52	$200.91	$251.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.29 / $169.10 / $211.38	Professional	TC	$138.29	$169.10	$211.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $208.19 / $320.95 / $3,140.08	Professional		$208.19	$320.95	$3,140.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.98 / $131.22 / $681.88	Professional	26	$74.98	$131.22	$681.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $96.02 / $160.12 / $2,808.09	Professional	TC	$96.02	$160.12	$2,808.09
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $209.01 / $209.01 / $209.01	Facility	26	$209.01	$209.01	$209.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $346.57 / $398.43 / $712.69	Professional		$346.57	$398.43	$712.69
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $218.91 / $299.31 / $317.64	Professional		$218.91	$299.31	$317.64
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $84.32 / $131.66 / $176.60	Professional	26	$84.32	$131.66	$176.60
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $99.90 / $138.44 / $221.50	Professional	TC	$99.90	$138.44	$221.50
United Facility/Professional Professional Modifier Low / Median / High Price $194.93 / $297.06 / $389.89	Professional		$194.93	$297.06	$389.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.74 / $124.98 / $172.92	Professional	26	$93.74	$124.98	$172.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.28 / $147.80 / $258.66	Professional	TC	$86.28	$147.80	$258.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $278.10 / $327.10 / $327.10	Professional		$278.10	$327.10	$327.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $155.90 / $183.40 / $183.40	Professional	26	$155.90	$183.40	$183.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $122.20 / $143.69 / $143.69	Professional	TC	$122.20	$143.69	$143.69