Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.34 / $109.34 / $109.34	Facility	26	$109.34	$109.34	$109.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.98 / $197.12 / $362.29	Professional		$126.98	$197.12	$362.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.51 / $106.16 / $235.21	Professional	26	$96.51	$106.16	$235.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.34 / $100.62 / $189.78	Professional	TC	$32.34	$100.62	$189.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.49 / $340.53 / $425.67	Professional		$278.49	$340.53	$425.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $203.00 / $248.22 / $310.27	Professional	26	$203.00	$248.22	$310.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.48 / $92.31 / $115.39	Professional	TC	$75.48	$92.31	$115.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.33 / $248.83 / $374.82	Professional		$140.33	$248.83	$374.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $115.89 / $201.17 / $360.00	Professional	26	$115.89	$201.17	$360.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.91 / $47.66 / $270.17	Professional	TC	$30.91	$47.66	$270.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $284.32 / $308.07 / $799.00	Professional		$284.32	$308.07	$799.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $180.11 / $249.66 / $284.64	Professional		$180.11	$249.66	$284.64
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $130.01 / $177.62 / $208.95	Professional	26	$130.01	$177.62	$208.95
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.32 / $66.39 / $78.45	Professional	TC	$44.32	$66.39	$78.45
United Facility/Professional Professional Modifier Low / Median / High Price $161.40 / $248.83 / $326.73	Professional		$161.40	$248.83	$326.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $126.42 / $130.49 / $210.70	Professional	26	$126.42	$130.49	$210.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.91 / $47.66 / $78.52	Professional	TC	$30.91	$47.66	$78.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $271.20 / $319.00 / $319.00	Professional		$271.20	$319.00	$319.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $199.00 / $234.20 / $234.20	Professional	26	$199.00	$234.20	$234.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $72.09 / $84.80 / $84.80	Professional	TC	$72.09	$84.80	$84.80