Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $851.09 / $851.09 / $1,014.15	Professional		$851.09	$851.09	$1,014.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $766.89 / $766.89 / $917.60	Professional	TC	$766.89	$766.89	$917.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,813.04 / $2,216.94 / $2,771.19	Professional		$1,813.04	$2,216.94	$2,771.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,637.32 / $2,002.08 / $2,502.60	Professional	TC	$1,637.32	$2,002.08	$2,502.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $863.46 / $1,544.29 / $1,719.12	Professional		$863.46	$1,544.29	$1,719.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $757.01 / $1,366.04 / $1,957.53	Professional	TC	$757.01	$1,366.04	$1,957.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $477.00 / $1,719.12 / $2,718.47	Professional		$477.00	$1,719.12	$2,718.47
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $951.34 / $1,360.09 / $1,824.26	Professional		$951.34	$1,360.09	$1,824.26
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $127.97 / $169.09 / $192.78	Professional	26	$127.97	$169.09	$192.78
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $826.87 / $1,216.35 / $1,631.48	Professional	TC	$826.87	$1,216.35	$1,631.48
United Facility/Professional Professional Modifier Low / Median / High Price $941.95 / $1,132.44 / $1,648.42	Professional		$941.95	$1,132.44	$1,648.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $757.01 / $1,013.00 / $1,403.98	Professional	TC	$757.01	$1,013.00	$1,403.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,044.50 / $2,044.50	Professional		$1,737.80	$2,044.50	$2,044.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $1,554.20 / $1,828.40 / $1,828.40	Professional	TC	$1,554.20	$1,828.40	$1,828.40