Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.30 / $53.30 / $53.30	Facility	26	$53.30	$53.30	$53.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.31 / $186.31 / $222.47	Professional		$186.31	$186.31	$222.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.83 / $53.30 / $177.30	Professional	26	$45.83	$53.30	$177.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.47 / $140.47 / $169.17	Professional	TC	$140.47	$140.47	$169.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.51 / $476.28 / $595.35	Professional		$389.51	$476.28	$595.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.06 / $118.68 / $148.35	Professional	26	$97.06	$118.68	$148.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $292.45 / $357.60 / $447.00	Professional	TC	$292.45	$357.60	$447.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.58 / $434.12 / $1,374.92	Professional		$281.58	$434.12	$1,374.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.48 / $103.38 / $330.16	Professional	26	$66.48	$103.38	$330.16
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $214.53 / $330.74 / $1,044.76	Professional	TC	$214.53	$330.74	$1,044.76
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $165.44 / $165.44 / $165.44	Facility	26	$165.44	$165.44	$165.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $431.95 / $525.41 / $643.73	Professional		$431.95	$525.41	$643.73
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $274.72 / $344.41 / $401.26	Professional		$274.72	$344.41	$401.26
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $56.94 / $87.95 / $100.27	Professional	26	$56.94	$87.95	$100.27
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $183.08 / $256.45 / $302.37	Professional	TC	$183.08	$256.45	$302.37
United Facility/Professional Professional Modifier Low / Median / High Price $247.66 / $356.25 / $498.75	Professional		$247.66	$356.25	$498.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.92 / $103.38 / $119.39	Professional	26	$61.92	$103.38	$119.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.74 / $330.74 / $397.73	Professional	TC	$185.74	$330.74	$397.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $451.90 / $531.60 / $531.60	Professional		$451.90	$531.60	$531.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $115.40 / $135.69 / $135.69	Professional	26	$115.40	$135.69	$135.69
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $336.50 / $395.90 / $395.90	Professional	TC	$336.50	$395.90	$395.90