Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.34 / $65.34 / $65.34	Facility	26	$65.34	$65.34	$65.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.57 / $345.37 / $379.91	Professional		$282.57	$345.37	$379.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.32 / $65.34 / $226.80	Professional	26	$56.32	$65.34	$226.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.25 / $284.95 / $313.45	Professional	TC	$226.25	$284.95	$313.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $590.60 / $722.18 / $902.72	Professional		$590.60	$722.18	$902.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.63 / $145.06 / $181.32	Professional	26	$118.63	$145.06	$181.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $471.98 / $577.12 / $721.40	Professional	TC	$471.98	$577.12	$721.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $295.41 / $460.71 / $769.12	Professional		$295.41	$460.71	$769.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $80.69 / $121.38 / $141.19	Professional	26	$80.69	$121.38	$141.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $333.39 / $500.09 / $601.86	Professional	TC	$333.39	$500.09	$601.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $591.45 / $745.42 / $911.62	Professional		$591.45	$745.42	$911.62
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $424.76 / $545.80 / $599.04	Professional		$424.76	$545.80	$599.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.52 / $107.24 / $122.26	Professional	26	$81.52	$107.24	$122.26
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $343.25 / $440.34 / $479.23	Professional	TC	$343.25	$440.34	$479.23
United Facility/Professional Professional Modifier Low / Median / High Price $375.08 / $424.61 / $707.68	Professional		$375.08	$424.61	$707.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.48 / $87.84 / $134.47	Professional	26	$75.48	$87.84	$134.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $299.58 / $403.92 / $573.20	Professional	TC	$299.58	$403.92	$573.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $524.10 / $616.60 / $616.60	Professional		$524.10	$616.60	$616.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $107.90 / $127.00 / $127.00	Professional	26	$107.90	$127.00	$127.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $416.20 / $489.70 / $489.70	Professional	TC	$416.20	$489.70	$489.70