Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $231.10 / $231.10 / $231.10	Facility	26	$231.10	$231.10	$231.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $432.13 / $557.72 / $986.73	Professional		$432.13	$557.72	$986.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $210.53 / $256.47 / $1,011.04	Professional	26	$210.53	$256.47	$1,011.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $232.54 / $347.18 / $693.98	Professional	TC	$232.54	$347.18	$693.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $930.63 / $1,137.95 / $1,422.44	Professional		$930.63	$1,137.95	$1,422.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $428.20 / $523.60 / $654.50	Professional	26	$428.20	$523.60	$654.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $502.43 / $614.35 / $767.94	Professional	TC	$502.43	$614.35	$767.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $467.14 / $912.51 / $1,110.86	Professional		$467.14	$912.51	$1,110.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $244.01 / $423.65 / $623.08	Professional	26	$244.01	$423.65	$623.08
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $317.10 / $488.86 / $775.60	Professional	TC	$317.10	$488.86	$775.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $942.56 / $1,110.86 / $1,947.00	Professional		$942.56	$1,110.86	$1,947.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $586.94 / $802.30 / $943.83	Professional		$586.94	$802.30	$943.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $266.87 / $369.04 / $440.54	Professional	26	$266.87	$369.04	$440.54
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $320.08 / $432.83 / $503.29	Professional	TC	$320.08	$432.83	$503.29
United Facility/Professional Professional Modifier Low / Median / High Price $576.01 / $644.58 / $1,009.79	Professional		$576.01	$644.58	$1,009.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $244.01 / $274.80 / $443.66	Professional	26	$244.01	$274.80	$443.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $308.37 / $384.13 / $545.50	Professional	TC	$308.37	$384.13	$545.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $899.10 / $1,057.80 / $1,057.80	Professional		$899.10	$1,057.80	$1,057.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $419.70 / $493.70 / $493.70	Professional	26	$419.70	$493.70	$493.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $479.40 / $564.10 / $564.10	Professional	TC	$479.40	$564.10	$564.10