Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.35 / $62.35 / $62.35	Facility	26	$62.35	$62.35	$62.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.64 / $236.03 / $275.08	Professional		$201.64	$236.03	$275.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.22 / $60.89 / $62.35	Professional	26	$54.22	$60.89	$62.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.41 / $173.68 / $192.46	Professional	TC	$147.41	$173.68	$192.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $419.32 / $512.74 / $640.91	Professional		$419.32	$512.74	$640.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.55 / $138.85 / $173.56	Professional	26	$113.55	$138.85	$173.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $305.77 / $373.89 / $467.36	Professional	TC	$305.77	$373.89	$467.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $209.95 / $434.44 / $637.03	Professional		$209.95	$434.44	$637.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.75 / $113.89 / $175.39	Professional	26	$68.75	$113.89	$175.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $195.26 / $317.39 / $576.54	Professional	TC	$195.26	$317.39	$576.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $429.76 / $510.40 / $673.00	Professional		$429.76	$510.40	$673.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $264.73 / $359.89 / $425.98	Professional		$264.73	$359.89	$425.98
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $75.08 / $101.54 / $118.38	Professional	26	$75.08	$101.54	$118.38
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $189.65 / $260.41 / $309.98	Professional	TC	$189.65	$260.41	$309.98
United Facility/Professional Professional Modifier Low / Median / High Price $265.24 / $434.44 / $492.70	Professional		$265.24	$434.44	$492.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.75 / $117.05 / $134.86	Professional	26	$68.75	$117.05	$134.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.54 / $317.39 / $343.02	Professional	TC	$192.54	$317.39	$343.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $419.70 / $493.80 / $493.80	Professional		$419.70	$493.80	$493.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $117.40 / $138.19 / $138.19	Professional	26	$117.40	$138.19	$138.19
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $302.30 / $355.60 / $355.60	Professional	TC	$302.30	$355.60	$355.60