Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.76 / $38.76 / $38.76	Facility	26	$38.76	$38.76	$38.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.65 / $244.01 / $459.38	Professional		$191.65	$244.01	$459.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $45.14 / $133.50	Professional	26	$32.20	$45.14	$133.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.46 / $210.64 / $399.82	Professional	TC	$159.46	$210.64	$399.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $519.54 / $635.29 / $794.12	Professional		$519.54	$635.29	$794.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.05 / $86.88 / $108.60	Professional	26	$71.05	$86.88	$108.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $448.50 / $548.41 / $685.52	Professional	TC	$448.50	$548.41	$685.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $259.07 / $508.30 / $616.04	Professional		$259.07	$508.30	$616.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.94 / $70.17 / $102.00	Professional	26	$39.94	$70.17	$102.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $265.85 / $440.03 / $687.46	Professional	TC	$265.85	$440.03	$687.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $301.00 / $616.04 / $755.88	Professional		$301.00	$616.04	$755.88
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $273.47 / $442.12 / $520.11	Professional		$273.47	$442.12	$520.11
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.33 / $59.58 / $73.09	Professional	26	$43.33	$59.58	$73.09
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $235.18 / $381.77 / $447.01	Professional	TC	$235.18	$381.77	$447.01
United Facility/Professional Professional Modifier Low / Median / High Price $322.75 / $338.87 / $555.98	Professional		$322.75	$338.87	$555.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.57 / $70.17 / $94.43	Professional	26	$43.57	$70.17	$94.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $207.98 / $293.35 / $483.36	Professional	TC	$207.98	$293.35	$483.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $495.50 / $582.90 / $582.90	Professional		$495.50	$582.90	$582.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.59 / $81.90 / $81.90	Professional	26	$69.59	$81.90	$81.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $425.80 / $501.00 / $501.00	Professional	TC	$425.80	$501.00	$501.00