Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $430.71 / $430.71 / $430.71	Facility	26	$430.71	$430.71	$430.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,664.03 / $2,114.63 / $3,320.59	Professional		$1,664.03	$2,114.63	$3,320.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $368.80 / $416.68 / $1,206.83	Professional	26	$368.80	$416.68	$1,206.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,292.05 / $1,745.82 / $2,807.44	Professional	TC	$1,292.05	$1,745.82	$2,807.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,568.99 / $4,364.09 / $5,455.11	Professional		$3,568.99	$4,364.09	$5,455.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $798.04 / $975.83 / $1,219.79	Professional	26	$798.04	$975.83	$1,219.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2,770.95 / $3,388.26 / $4,235.32	Professional	TC	$2,770.95	$3,388.26	$4,235.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,783.83 / $3,485.57 / $4,334.38	Professional		$1,783.83	$3,485.57	$4,334.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $496.31 / $788.71 / $1,161.70	Professional	26	$496.31	$788.71	$1,161.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $1,719.84 / $2,718.18 / $4,446.34	Professional	TC	$1,719.84	$2,718.18	$4,446.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,660.00 / $4,169.06 / $5,050.79	Professional		$2,660.00	$4,169.06	$5,050.79
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $2,089.15 / $3,149.91 / $3,595.47	Professional		$2,089.15	$3,149.91	$3,595.47
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $491.29 / $682.51 / $822.21	Professional	26	$491.29	$682.51	$822.21
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $1,647.14 / $2,443.58 / $2,773.26	Professional	TC	$1,647.14	$2,443.58	$2,773.26
United Facility/Professional Professional Modifier Low / Median / High Price $2,174.79 / $2,372.50 / $3,954.16	Professional		$2,174.79	$2,372.50	$3,954.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $454.95 / $511.60 / $918.70	Professional	26	$454.95	$511.60	$918.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,712.45 / $2,718.18 / $3,283.33	Professional	TC	$1,712.45	$2,718.18	$3,283.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $3,425.10 / $4,029.50 / $4,029.50	Professional		$3,425.10	$4,029.50	$4,029.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $783.30 / $921.50 / $921.50	Professional	26	$783.30	$921.50	$921.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $2,641.90 / $3,108.10 / $3,108.10	Professional	TC	$2,641.90	$3,108.10	$3,108.10