Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.79 / $40.79 / $40.79	Facility	26	$40.79	$40.79	$40.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.26 / $257.33 / $450.52	Professional		$243.26	$257.33	$450.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.69 / $40.79 / $150.30	Professional	26	$37.69	$40.79	$150.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.26 / $218.37 / $388.90	Professional	TC	$208.26	$218.37	$388.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $509.40 / $622.89 / $778.61	Professional		$509.40	$622.89	$778.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.22 / $90.76 / $113.45	Professional	26	$74.22	$90.76	$113.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $435.18 / $532.13 / $665.16	Professional	TC	$435.18	$532.13	$665.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $254.59 / $370.57 / $683.78	Professional		$254.59	$370.57	$683.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.42 / $76.56 / $99.15	Professional	26	$46.42	$76.56	$99.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $242.07 / $440.12 / $492.62	Professional	TC	$242.07	$440.12	$492.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $376.00 / $563.60 / $801.43	Professional		$376.00	$563.60	$801.43
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $279.57 / $431.22 / $517.46	Professional		$279.57	$431.22	$517.46
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.49 / $67.52 / $76.98	Professional	26	$51.49	$67.52	$76.98
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $239.24 / $360.43 / $435.36	Professional	TC	$239.24	$360.43	$435.36
United Facility/Professional Professional Modifier Low / Median / High Price $288.49 / $370.57 / $571.29	Professional		$288.49	$370.57	$571.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.42 / $51.04 / $84.40	Professional	26	$46.42	$51.04	$84.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.07 / $319.52 / $492.62	Professional	TC	$242.07	$319.52	$492.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $452.20 / $532.00 / $532.00	Professional		$452.20	$532.00	$532.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $79.90 / $79.90	Professional	26	$67.90	$79.90	$79.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $384.20 / $452.10 / $452.10	Professional	TC	$384.20	$452.10	$452.10