Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Facility	26	$83.18	$83.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $537.03 / $1,096.48	Professional		$467.74	$537.03	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $87.10 / $281.84	Professional	26	$77.62	$87.10	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $467.74 / $891.25	Professional	TC	$380.19	$467.74	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,071.52 / $1,348.96	Professional		$977.24	$1,071.52	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $194.98 / $245.47	Professional	26	$177.83	$194.98	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $870.96 / $1,096.48	Professional	TC	$794.33	$870.96	$1,096.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $676.08 / $1,148.15	Professional		$436.52	$676.08	$1,148.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $112.20 / $173.78	Professional	26	$77.62	$112.20	$173.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $575.44 / $933.25	Professional	TC	$363.08	$575.44	$933.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional		$1,148.15	$1,148.15	$1,148.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	26	$190.55	$190.55	$190.55
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $954.99 / $954.99 / $954.99	Professional	TC	$954.99	$954.99	$954.99
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $831.76 / $870.96	Professional		$588.84	$831.76	$870.96
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $134.90 / $162.18	Professional	26	$97.72	$134.90	$162.18
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $691.83 / $724.44	Professional	TC	$478.63	$691.83	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $741.31 / $1,096.48	Professional		$537.03	$741.31	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $128.82 / $199.53	Professional	26	$89.13	$128.82	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $616.60 / $933.25	Professional	TC	$436.52	$616.60	$933.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $954.99 / $954.99	Professional		$812.83	$954.99	$954.99
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $177.83 / $177.83	Professional	26	$151.36	$177.83	$177.83
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $776.25 / $776.25	Professional	TC	$660.69	$776.25	$776.25