Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.39 / $77.39 / $77.39	Facility	26	$77.39	$77.39	$77.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.60 / $371.25 / $522.50	Professional		$202.60	$371.25	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.36 / $116.83 / $154.00	Professional	26	$66.36	$116.83	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.24 / $254.41 / $368.50	Professional	TC	$136.24	$254.41	$368.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.67 / $520.49 / $650.62	Professional		$425.67	$520.49	$650.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.19 / $171.43 / $214.29	Professional	26	$140.19	$171.43	$214.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $285.47 / $349.07 / $436.33	Professional	TC	$285.47	$349.07	$436.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $306.61 / $596.79 / $1,484.56	Professional		$306.61	$596.79	$1,484.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $96.12 / $148.19 / $478.82	Professional	26	$96.12	$148.19	$478.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $208.31 / $553.04 / $1,005.68	Professional	TC	$208.31	$553.04	$1,005.68
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $238.72 / $238.72 / $238.72	Facility	26	$238.72	$238.72	$238.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $473.22 / $570.73 / $698.97	Professional		$473.22	$570.73	$698.97
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $298.16 / $377.32 / $435.49	Professional		$298.16	$377.32	$435.49
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $82.17 / $127.67 / $145.55	Professional	26	$82.17	$127.67	$145.55
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $177.67 / $249.66 / $292.23	Professional	TC	$177.67	$249.66	$292.23
United Facility/Professional Professional Modifier Low / Median / High Price $269.63 / $468.90 / $1,085.08	Professional		$269.63	$468.90	$1,085.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.47 / $148.19 / $175.96	Professional	26	$89.47	$148.19	$175.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.16 / $320.70 / $943.42	Professional	TC	$180.16	$320.70	$943.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $495.00 / $582.40 / $582.40	Professional		$495.00	$582.40	$582.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $167.50 / $197.10 / $197.10	Professional	26	$167.50	$197.10	$197.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $327.50 / $385.40 / $385.40	Professional	TC	$327.50	$385.40	$385.40