Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.71 / $107.71 / $107.71	Facility	26	$107.71	$107.71	$107.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $369.01 / $417.25 / $682.63	Professional		$369.01	$417.25	$682.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.32 / $103.42 / $167.18	Professional	26	$93.32	$103.42	$167.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.70 / $323.22 / $515.44	Professional	TC	$275.70	$323.22	$515.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $777.74 / $951.01 / $1,188.76	Professional		$777.74	$951.01	$1,188.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $199.83 / $244.35 / $305.43	Professional	26	$199.83	$244.35	$305.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $577.91 / $706.66 / $883.33	Professional	TC	$577.91	$706.66	$883.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $391.73 / $824.63 / $1,030.49	Professional		$391.73	$824.63	$1,030.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $115.39 / $198.51 / $291.87	Professional	26	$115.39	$198.51	$291.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $405.35 / $631.49 / $1,048.18	Professional	TC	$405.35	$631.49	$1,048.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $805.35 / $957.52 / $1,187.58	Professional		$805.35	$957.52	$1,187.58
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $557.34 / $742.44 / $783.50	Professional		$557.34	$742.44	$783.50
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $124.43 / $174.32 / $205.07	Professional	26	$124.43	$174.32	$205.07
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $422.18 / $547.61 / $595.21	Professional	TC	$422.18	$547.61	$595.21
United Facility/Professional Professional Modifier Low / Median / High Price $489.32 / $824.63 / $1,140.38	Professional		$489.32	$824.63	$1,140.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $124.70 / $198.51 / $207.84	Professional	26	$124.70	$198.51	$207.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $364.29 / $421.00 / $737.00	Professional	TC	$364.29	$421.00	$737.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $744.40 / $875.80 / $875.80	Professional		$744.40	$875.80	$875.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $195.40 / $229.80 / $229.80	Professional	26	$195.40	$229.80	$229.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $549.10 / $646.00 / $646.00	Professional	TC	$549.10	$646.00	$646.00