Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,023.29 / $1,584.89	Professional		$851.14	$1,023.29	$1,584.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $912.01 / $1,445.44	Professional	TC	$758.58	$912.01	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,290.87 / $2,818.38	Professional		$1,862.09	$2,290.87	$2,818.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,659.59 / $2,041.74 / $2,570.40	Professional	TC	$1,659.59	$2,041.74	$2,570.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,023.29 / $1,737.80	Professional		$741.31	$1,023.29	$1,737.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $912.01 / $1,445.44	Professional	TC	$645.65	$912.01	$1,445.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	26	$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Professional	TC	$1,479.11	$1,479.11	$1,479.11
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,548.82 / $1,819.70	Professional		$954.99	$1,548.82	$1,819.70
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $173.78 / $194.98	Professional	26	$128.82	$173.78	$194.98
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $831.76 / $1,380.38 / $1,621.81	Professional	TC	$831.76	$1,380.38	$1,621.81
United Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,202.26 / $2,238.72	Professional		$870.96	$1,202.26	$2,238.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $1,023.29 / $1,949.84	Professional	TC	$724.44	$1,023.29	$1,949.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,041.74 / $2,041.74	Professional		$1,737.80	$2,041.74	$2,041.74
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $1,548.82 / $1,819.70 / $1,819.70	Professional	TC	$1,548.82	$1,819.70	$1,819.70