Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.59 / $43.59 / $43.59	Facility	26	$43.59	$43.59	$43.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.29 / $219.04 / $219.04	Professional		$185.29	$219.04	$219.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.68 / $175.44 / $175.44	Professional	TC	$147.68	$175.44	$175.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.68 / $480.16 / $600.20	Professional		$392.68	$480.16	$600.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $312.75 / $382.42 / $478.03	Professional	TC	$312.75	$382.42	$478.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $196.36 / $308.06 / $512.02	Professional		$196.36	$308.06	$512.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $219.94 / $329.90 / $401.83	Professional	TC	$219.94	$329.90	$401.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $435.51 / $486.87 / $590.15	Professional		$435.51	$486.87	$590.15
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $347.25 / $395.90	Professional		$282.88	$347.25	$395.90
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $55.13 / $72.63 / $82.80	Professional	26	$55.13	$72.63	$82.80
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $223.62 / $280.16 / $314.41	Professional	TC	$223.62	$280.16	$314.41
United Facility/Professional Professional Modifier Low / Median / High Price $246.06 / $283.97 / $473.28	Professional		$246.06	$283.97	$473.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.73 / $248.97 / $382.70	Professional	TC	$195.73	$248.97	$382.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $349.40 / $411.10 / $411.10	Professional		$349.40	$411.10	$411.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $276.30 / $325.10 / $325.10	Professional	TC	$276.30	$325.10	$325.10