Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.89 / $42.89 / $42.89	Facility	26	$42.89	$42.89	$42.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $430.30 / $436.79 / $680.84	Professional		$430.30	$436.79	$680.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.74 / $42.89 / $115.70	Professional	26	$37.74	$42.89	$115.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $387.41 / $399.06 / $627.04	Professional	TC	$387.41	$399.06	$627.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $753.64 / $921.53 / $1,151.91	Professional		$753.64	$921.53	$1,151.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.03 / $95.41 / $119.26	Professional	26	$78.03	$95.41	$119.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $675.61 / $826.12 / $1,032.65	Professional	TC	$675.61	$826.12	$1,032.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $388.67 / $610.47 / $1,007.64	Professional		$388.67	$610.47	$1,007.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.35 / $80.44 / $93.43	Professional	26	$49.35	$80.44	$93.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $476.28 / $738.11 / $891.58	Professional	TC	$476.28	$738.11	$891.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $723.42 / $981.89 / $1,180.27	Professional		$723.42	$981.89	$1,180.27
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $547.35 / $717.85 / $772.72	Professional		$547.35	$717.85	$772.72
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.06 / $72.06 / $80.86	Professional	26	$54.06	$72.06	$80.86
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $490.51 / $641.03 / $694.90	Professional	TC	$490.51	$641.03	$694.90
United Facility/Professional Professional Modifier Low / Median / High Price $476.94 / $562.86 / $938.10	Professional		$476.94	$562.86	$938.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.35 / $80.44 / $88.98	Professional	26	$49.35	$80.44	$88.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $427.40 / $552.27 / $849.12	Professional	TC	$427.40	$552.27	$849.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $666.90 / $784.50 / $784.50	Professional		$666.90	$784.50	$784.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $71.40 / $84.00 / $84.00	Professional	26	$71.40	$84.00	$84.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $595.50 / $700.60 / $700.60	Professional	TC	$595.50	$700.60	$700.60