Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $302.00 / $707.95	Professional		$269.15	$302.00	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $162.18 / $354.81	Professional	26	$138.04	$162.18	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $144.54 / $323.59	Professional	TC	$131.83	$144.54	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $691.83 / $870.96	Professional		$630.96	$691.83	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $363.08 / $457.09	Professional	26	$331.13	$363.08	$457.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $331.13 / $416.87	Professional	TC	$302.00	$331.13	$416.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $660.69	Professional		$281.84	$380.19	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $194.98 / $316.23	Professional	26	$134.90	$194.98	$316.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $181.97 / $295.12	Professional	TC	$117.49	$181.97	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Professional		$660.69	$660.69	$660.69
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	26	$354.81	$354.81	$354.81
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $302.00	Professional	TC	$302.00	$302.00	$302.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $562.34	Professional		$371.54	$478.63	$562.34
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $257.04 / $302.00	Professional	26	$194.98	$257.04	$302.00
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $234.42 / $269.15	Professional	TC	$173.78	$234.42	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $436.52 / $660.69	Professional		$323.59	$436.52	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $239.88 / $338.84	Professional	26	$165.96	$239.88	$338.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $199.53 / $316.23	Professional	TC	$154.88	$199.53	$316.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $630.96 / $630.96	Professional		$537.03	$630.96	$630.96
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $331.13 / $331.13	Professional	26	$281.84	$331.13	$331.13
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $302.00 / $302.00	Professional	TC	$257.04	$302.00	$302.00