Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $274.79 / $681.18 / $1,270.80	Facility		$274.79	$681.18	$1,270.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.04 / $39.04 / $39.04	Facility	26	$39.04	$39.04	$39.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.59 / $136.33 / $203.24	Professional		$104.59	$136.33	$203.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.77 / $57.32 / $136.80	Professional	26	$36.77	$57.32	$136.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.15 / $142.21 / $274.50	Professional	TC	$78.15	$142.21	$274.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.61 / $269.94 / $337.43	Professional		$176.61	$269.94	$337.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.84 / $86.88 / $108.60	Professional	26	$56.84	$86.88	$108.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.77 / $183.07 / $228.83	Professional	TC	$119.77	$183.07	$228.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $160.99 / $190.95 / $286.58	Facility		$160.99	$190.95	$286.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.23 / $229.14 / $760.68	Professional		$125.23	$229.14	$760.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.44 / $75.33 / $303.79	Professional	26	$44.44	$75.33	$303.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.75 / $153.81 / $518.02	Professional	TC	$91.75	$153.81	$518.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $217.93 / $270.82 / $391.72	Facility		$217.93	$270.82	$391.72
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $127.83 / $127.83 / $127.83	Facility	26	$127.83	$127.83	$127.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $210.00 / $271.77 / $301.99	Professional		$210.00	$271.77	$301.99
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $137.13 / $196.32 / $223.83	Professional		$137.13	$196.32	$223.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $47.74 / $64.68 / $73.75	Professional	26	$47.74	$64.68	$73.75
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $92.73 / $131.63 / $150.22	Professional	TC	$92.73	$131.63	$150.22
United Facility/Professional Professional Modifier Low / Median / High Price $136.19 / $162.77 / $247.62	Professional		$136.19	$162.77	$247.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.59 / $52.81 / $80.80	Professional	26	$40.59	$52.81	$80.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.75 / $110.12 / $166.82	Professional	TC	$91.75	$110.12	$166.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $205.10 / $241.30 / $241.30	Professional		$205.10	$241.30	$241.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $79.50 / $79.50	Professional	26	$67.59	$79.50	$79.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $137.50 / $161.80 / $161.80	Professional	TC	$137.50	$161.80	$161.80