Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.56 / $70.56 / $70.56	Facility	26	$70.56	$70.56	$70.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.81 / $163.03 / $289.82	Professional		$125.81	$163.03	$289.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $76.09 / $247.42	Professional	26	$52.54	$76.09	$247.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.73 / $110.48 / $160.22	Professional	TC	$64.73	$110.48	$160.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.53 / $291.66 / $364.58	Professional		$238.53	$291.66	$364.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.51 / $155.91 / $194.89	Professional	26	$127.51	$155.91	$194.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.02 / $135.75 / $169.68	Professional	TC	$111.02	$135.75	$169.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $149.08 / $272.63 / $1,406.40	Professional		$149.08	$272.63	$1,406.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.38 / $132.72 / $439.49	Professional	26	$68.38	$132.72	$439.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $139.90 / $1,140.03	Professional	TC	$80.70	$139.90	$1,140.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $178.99 / $178.99 / $178.99	Facility	26	$178.99	$178.99	$178.99
Midlands Facility/Professional Professional Modifier Low / Median / High Price $258.13 / $340.20 / $444.47	Professional		$258.13	$340.20	$444.47
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $207.86 / $247.76	Professional		$151.16	$207.86	$247.76
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.48 / $110.76 / $133.26	Professional	26	$70.48	$110.76	$133.26
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $80.95 / $105.71 / $127.73	Professional	TC	$80.95	$105.71	$127.73
United Facility/Professional Professional Modifier Low / Median / High Price $166.57 / $248.46 / $280.20	Professional		$166.57	$248.46	$280.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.56 / $117.40 / $136.41	Professional	26	$74.56	$117.40	$136.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.68 / $143.78 / $155.41	Professional	TC	$84.68	$143.78	$155.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $214.50 / $252.30 / $252.30	Professional		$214.50	$252.30	$252.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $116.90 / $137.50 / $137.50	Professional	26	$116.90	$137.50	$137.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $97.60 / $114.80 / $114.80	Professional	TC	$97.60	$114.80	$114.80