Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.16 / $48.16 / $48.16	Facility	26	$48.16	$48.16	$48.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.88 / $182.14 / $567.82	Professional		$142.88	$182.14	$567.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.95 / $49.30 / $130.83	Professional	26	$41.95	$49.30	$130.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.96 / $174.38 / $480.60	Professional	TC	$107.96	$174.38	$480.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.50 / $372.34 / $465.42	Professional		$304.50	$372.34	$465.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.54 / $107.05 / $133.81	Professional	26	$87.54	$107.05	$133.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.96 / $265.29 / $331.61	Professional	TC	$216.96	$265.29	$331.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.64 / $315.27 / $1,024.30	Professional		$186.64	$315.27	$1,024.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.86 / $92.71 / $300.10	Professional	26	$57.86	$92.71	$300.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $142.13 / $222.57 / $724.19	Professional	TC	$142.13	$222.57	$724.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $163.76 / $163.76 / $163.76	Facility	26	$163.76	$163.76	$163.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $324.35 / $376.92 / $433.32	Professional		$324.35	$376.92	$433.32
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $199.31 / $269.52 / $307.27	Professional		$199.31	$269.52	$307.27
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $79.44 / $90.57	Professional	26	$51.54	$79.44	$90.57
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $120.37 / $190.08 / $216.71	Professional	TC	$120.37	$190.08	$216.71
United Facility/Professional Professional Modifier Low / Median / High Price $190.14 / $315.27 / $357.52	Professional		$190.14	$315.27	$357.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $77.97 / $96.44	Professional	26	$55.92	$77.97	$96.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.22 / $222.57 / $318.06	Professional	TC	$134.22	$222.57	$318.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $292.70 / $344.40 / $344.40	Professional		$292.70	$344.40	$344.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $86.30 / $101.50 / $101.50	Professional	26	$86.30	$101.50	$101.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $206.40 / $242.90 / $242.90	Professional	TC	$206.40	$242.90	$242.90