Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.16 / $111.16 / $111.16	Facility	26	$111.16	$111.16	$111.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.37 / $475.00 / $1,143.65	Professional		$317.37	$475.00	$1,143.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.85 / $168.71 / $323.07	Professional	26	$102.85	$168.71	$323.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $221.78 / $335.00 / $829.80	Professional	TC	$221.78	$335.00	$829.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $666.09 / $814.49 / $1,018.11	Professional		$666.09	$814.49	$1,018.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $202.37 / $247.45 / $309.31	Professional	26	$202.37	$247.45	$309.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $463.73 / $567.04 / $708.80	Professional	TC	$463.73	$567.04	$708.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $481.06 / $741.63 / $2,337.81	Professional		$481.06	$741.63	$2,337.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $101.81 / $182.41 / $687.65	Professional	26	$101.81	$182.41	$687.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $343.43 / $571.63 / $1,650.16	Professional	TC	$343.43	$571.63	$1,650.16
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $341.30 / $341.30 / $341.30	Facility	26	$341.30	$341.30	$341.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $740.81 / $900.27 / $1,254.71	Professional		$740.81	$900.27	$1,254.71
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $466.98 / $590.66 / $682.08	Professional		$466.98	$590.66	$682.08
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $184.97 / $210.89	Professional	26	$117.49	$184.97	$210.89
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $293.00 / $405.69 / $476.06	Professional	TC	$293.00	$405.69	$476.06
United Facility/Professional Professional Modifier Low / Median / High Price $422.22 / $741.63 / $1,178.52	Professional		$422.22	$741.63	$1,178.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.05 / $169.68 / $213.01	Professional	26	$115.05	$169.68	$213.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $293.20 / $528.62 / $961.20	Professional	TC	$293.20	$528.62	$961.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $775.00 / $911.70 / $911.70	Professional		$775.00	$911.70	$911.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $242.70 / $285.50 / $285.50	Professional	26	$242.70	$285.50	$285.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $532.29 / $626.20 / $626.20	Professional	TC	$532.29	$626.20	$626.20