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 $416.87 / $478.63 / $724.44	Professional		$416.87	$478.63	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $158.49 / $257.04	Professional	26	$134.90	$158.49	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $323.59 / $478.63	Professional	TC	$257.04	$323.59	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,122.02 / $1,380.38	Professional		$891.25	$1,122.02	$1,380.38
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 $602.56 / $758.58 / $933.25	Professional	TC	$602.56	$758.58	$933.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $501.19 / $870.96	Professional		$389.05	$501.19	$870.96
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 $223.87 / $288.40 / $478.63	Professional	TC	$223.87	$288.40	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Professional		$870.96	$870.96	$870.96
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 $512.86 / $512.86 / $512.86	Professional	TC	$512.86	$512.86	$512.86
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $758.58 / $891.25	Professional		$512.86	$758.58	$891.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $257.04 / $295.12	Professional	26	$194.98	$257.04	$295.12
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $512.86 / $602.56	Professional	TC	$309.03	$512.86	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $575.44 / $1,000.00	Professional		$389.05	$575.44	$1,000.00
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 $229.09 / $371.54 / $676.08	Professional	TC	$229.09	$371.54	$676.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,000.00 / $1,000.00	Professional		$851.14	$1,000.00	$1,000.00
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 $575.44 / $676.08 / $676.08	Professional	TC	$575.44	$676.08	$676.08