Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $61.66 / $61.66	Facility	26	$43.65	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $436.52	Professional		$199.53	$245.47	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $67.61 / $117.49	Professional	26	$53.70	$67.61	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $177.83 / $316.23	Professional	TC	$147.91	$177.83	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $524.81 / $660.69	Professional		$478.63	$524.81	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $141.25 / $177.83	Professional	26	$128.82	$141.25	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $380.19 / $478.63	Professional	TC	$346.74	$380.19	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $316.23 / $630.96	Professional		$208.93	$316.23	$630.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $134.90	Professional	26	$54.95	$81.28	$134.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $229.09 / $467.74	Professional	TC	$144.54	$229.09	$467.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	26	$144.54	$144.54	$144.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $363.08 / $363.08	Professional	TC	$363.08	$363.08	$363.08
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $371.54 / $478.63	Professional		$302.00	$371.54	$478.63
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $102.33 / $117.49	Professional	26	$75.86	$102.33	$117.49
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $269.15 / $346.74	Professional	TC	$218.78	$269.15	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $426.58 / $616.60	Professional		$263.03	$426.58	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $87.10 / $134.90	Professional	26	$60.26	$87.10	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $316.23 / $446.68	Professional	TC	$190.55	$316.23	$446.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $489.78 / $489.78	Professional		$416.87	$489.78	$489.78
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $138.04 / $138.04	Professional	26	$117.49	$138.04	$138.04
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $354.81 / $354.81	Professional	TC	$302.00	$354.81	$354.81