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 $420.85 / $470.83 / $788.94	Professional		$420.85	$470.83	$788.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $200.11 / $223.87 / $612.32	Professional	26	$200.11	$223.87	$612.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.96 / $270.72 / $430.21	Professional	TC	$220.96	$270.72	$430.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $909.06 / $1,111.58 / $1,389.47	Professional		$909.06	$1,111.58	$1,389.47
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 $480.86 / $587.98 / $734.98	Professional	TC	$480.86	$587.98	$734.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $456.59 / $885.73 / $1,127.55	Professional		$456.59	$885.73	$1,127.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $266.20 / $423.65 / $577.67	Professional	26	$266.20	$423.65	$577.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $315.68 / $473.53 / $823.93	Professional	TC	$315.68	$473.53	$823.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $913.81 / $1,042.65 / $1,254.05	Professional		$913.81	$1,042.65	$1,254.05
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $535.83 / $809.68 / $923.13	Professional		$535.83	$809.68	$923.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $237.03 / $366.92 / $440.54	Professional	26	$237.03	$366.92	$440.54
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $293.64 / $423.28 / $482.59	Professional	TC	$293.64	$423.28	$482.59
United Facility/Professional Professional Modifier Low / Median / High Price $561.62 / $885.73 / $1,023.18	Professional		$561.62	$885.73	$1,023.18
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 $293.58 / $347.71 / $579.52	Professional	TC	$293.58	$347.71	$579.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $879.40 / $1,034.59 / $1,034.59	Professional		$879.40	$1,034.59	$1,034.59
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 $459.70 / $540.90 / $540.90	Professional	TC	$459.70	$540.90	$540.90