Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.61 / $50.61 / $50.61	Facility	26	$50.61	$50.61	$50.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.77 / $326.70 / $505.16	Professional		$273.77	$326.70	$505.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.68 / $50.61 / $181.56	Professional	26	$44.68	$50.61	$181.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $230.19 / $276.10 / $428.87	Professional	TC	$230.19	$276.10	$428.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $572.21 / $699.68 / $874.60	Professional		$572.21	$699.68	$874.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.98 / $112.48 / $140.60	Professional	26	$91.98	$112.48	$140.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $480.22 / $587.20 / $734.01	Professional	TC	$480.22	$587.20	$734.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $292.64 / $454.64 / $756.55	Professional		$292.64	$454.64	$756.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.49 / $94.74 / $111.07	Professional	26	$58.49	$94.74	$111.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $325.92 / $520.88 / $622.21	Professional	TC	$325.92	$520.88	$622.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $517.39 / $695.52 / $891.58	Professional		$517.39	$695.52	$891.58
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $417.05 / $546.38 / $586.99	Professional		$417.05	$546.38	$586.99
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $64.36 / $85.80 / $95.09	Professional	26	$64.36	$85.80	$95.09
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $349.77 / $456.03 / $493.81	Professional	TC	$349.77	$456.03	$493.81
United Facility/Professional Professional Modifier Low / Median / High Price $363.50 / $454.64 / $698.36	Professional		$363.50	$454.64	$698.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.49 / $69.19 / $111.07	Professional	26	$58.49	$69.19	$111.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $246.94 / $347.25 / $592.58	Professional	TC	$246.94	$347.25	$592.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $507.60 / $597.10 / $597.10	Professional		$507.60	$597.10	$597.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $83.90 / $98.70 / $98.70	Professional	26	$83.90	$98.70	$98.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $423.60 / $498.40 / $498.40	Professional	TC	$423.60	$498.40	$498.40