Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.90 / $104.90 / $104.90	Facility	26	$104.90	$104.90	$104.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.43 / $363.57 / $590.40	Professional		$312.43	$363.57	$590.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.89 / $104.90 / $334.64	Professional	26	$90.89	$104.90	$334.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $219.11 / $258.67 / $426.90	Professional	TC	$219.11	$258.67	$426.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $673.71 / $823.79 / $1,029.74	Professional		$673.71	$823.79	$1,029.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $195.39 / $238.92 / $298.64	Professional	26	$195.39	$238.92	$298.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $478.32 / $584.88 / $731.10	Professional	TC	$478.32	$584.88	$731.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $336.92 / $612.45 / $740.44	Professional		$336.92	$612.45	$740.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $113.40 / $192.92 / $283.44	Professional	26	$113.40	$192.92	$283.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $247.10 / $424.75 / $634.37	Professional	TC	$247.10	$424.75	$634.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $619.63 / $740.44 / $922.56	Professional		$619.63	$740.44	$922.56
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $354.20 / $576.85 / $678.60	Professional		$354.20	$576.85	$678.60
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $104.51 / $170.47 / $200.54	Professional	26	$104.51	$170.47	$200.54
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $244.45 / $406.38 / $478.06	Professional	TC	$244.45	$406.38	$478.06
United Facility/Professional Professional Modifier Low / Median / High Price $360.50 / $417.42 / $647.96	Professional		$360.50	$417.42	$647.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $113.40 / $125.14 / $201.80	Professional	26	$113.40	$125.14	$201.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $247.10 / $295.58 / $446.16	Professional	TC	$247.10	$295.58	$446.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $646.40 / $760.50 / $760.50	Professional		$646.40	$760.50	$760.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $191.00 / $224.80 / $224.80	Professional	26	$191.00	$224.80	$224.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $455.40 / $535.79 / $535.79	Professional	TC	$455.40	$535.79	$535.79