Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $489.78 / $1,479.11	Professional		$398.11	$489.78	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $77.62 / $213.80	Professional	26	$70.79	$77.62	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $416.87 / $870.96	Professional	TC	$323.59	$416.87	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,023.29 / $1,258.93	Professional		$831.76	$1,023.29	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $173.78 / $218.78	Professional	26	$141.25	$173.78	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $851.14 / $1,047.13	Professional	TC	$691.83	$851.14	$1,047.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $645.65 / $1,071.52	Professional		$407.38	$645.65	$1,071.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $123.03 / $190.55	Professional	26	$87.10	$123.03	$190.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $562.34 / $1,174.90	Professional	TC	$346.74	$562.34	$1,174.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional		$1,071.52	$1,071.52	$1,071.52
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	26	$186.21	$186.21	$186.21
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $891.25 / $891.25	Professional	TC	$891.25	$891.25	$891.25
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $812.83 / $831.76	Professional		$588.84	$812.83	$831.76
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $131.83 / $144.54	Professional	26	$97.72	$131.83	$144.54
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $676.08 / $691.83	Professional	TC	$489.78	$676.08	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $794.33 / $1,023.29	Professional		$524.81	$794.33	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $134.90 / $169.82	Professional	26	$89.13	$134.90	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $645.65 / $870.96	Professional	TC	$426.58	$645.65	$870.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $851.14 / $851.14	Professional		$724.44	$851.14	$851.14
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $151.36 / $151.36	Professional	26	$125.89	$151.36	$151.36
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $691.83 / $691.83	Professional	TC	$588.84	$691.83	$691.83