Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.63 / $37.63 / $37.63	Facility	26	$37.63	$37.63	$37.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.76 / $282.76 / $506.41	Professional		$282.76	$282.76	$506.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.15 / $55.26 / $156.63	Professional	26	$35.15	$55.26	$156.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.61 / $251.51 / $449.49	Professional	TC	$247.61	$251.51	$449.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $572.21 / $699.68 / $874.60	Professional		$572.21	$699.68	$874.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.51 / $83.78 / $104.72	Professional	26	$68.51	$83.78	$104.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $503.69 / $615.91 / $769.88	Professional	TC	$503.69	$615.91	$769.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $285.44 / $457.39 / $756.17	Professional		$285.44	$457.39	$756.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.87 / $72.17 / $92.96	Professional	26	$42.87	$72.17	$92.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $343.68 / $544.92 / $656.12	Professional	TC	$343.68	$544.92	$656.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $358.00 / $663.24 / $889.78	Professional		$358.00	$663.24	$889.78
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $312.44 / $489.49 / $584.46	Professional		$312.44	$489.49	$584.46
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $47.81 / $62.41 / $71.16	Professional	26	$47.81	$62.41	$71.16
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $275.16 / $429.45 / $514.73	Professional	TC	$275.16	$429.45	$514.73
United Facility/Professional Professional Modifier Low / Median / High Price $361.90 / $421.69 / $702.82	Professional		$361.90	$421.69	$702.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $46.81 / $77.94	Professional	26	$33.75	$46.81	$77.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $258.27 / $374.93 / $624.88	Professional	TC	$258.27	$374.93	$624.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $507.00 / $596.50 / $596.50	Professional		$507.00	$596.50	$596.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $62.80 / $73.90 / $73.90	Professional	26	$62.80	$73.90	$73.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $444.20 / $522.60 / $522.60	Professional	TC	$444.20	$522.60	$522.60