Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.40 / $46.40 / $46.40	Facility	26	$46.40	$46.40	$46.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.64 / $223.98 / $280.83	Professional		$189.64	$223.98	$280.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.14 / $46.40 / $49.92	Professional	26	$40.14	$46.40	$49.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $149.50 / $177.58 / $230.90	Professional	TC	$149.50	$177.58	$230.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.12 / $485.59 / $606.99	Professional		$397.12	$485.59	$606.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.37 / $103.17 / $128.96	Professional	26	$84.37	$103.17	$128.96
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 $199.70 / $309.97 / $518.50	Professional		$199.70	$309.97	$518.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $52.89 / $86.94 / $100.97	Professional	26	$52.89	$86.94	$100.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $221.78 / $332.68 / $398.83	Professional	TC	$221.78	$332.68	$398.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $440.48 / $501.59 / $610.16	Professional		$440.48	$501.59	$610.16
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $286.18 / $351.22 / $403.79	Professional		$286.18	$351.22	$403.79
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.36 / $76.59 / $87.33	Professional	26	$58.36	$76.59	$87.33
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $227.38 / $274.62 / $318.22	Professional	TC	$227.38	$274.62	$318.22
United Facility/Professional Professional Modifier Low / Median / High Price $252.05 / $419.62 / $476.00	Professional		$252.05	$419.62	$476.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.89 / $62.86 / $97.13	Professional	26	$52.89	$62.86	$97.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.12 / $233.57 / $379.84	Professional	TC	$198.12	$233.57	$379.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $353.40 / $415.80 / $415.80	Professional		$353.40	$415.80	$415.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $77.09 / $90.70 / $90.70	Professional	26	$77.09	$90.70	$90.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $276.30 / $325.10 / $325.10	Professional	TC	$276.30	$325.10	$325.10