Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.92 / $56.92 / $56.92	Facility	26	$56.92	$56.92	$56.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $157.16 / $179.96 / $294.18	Professional		$157.16	$179.96	$294.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.90 / $54.73 / $151.30	Professional	26	$53.90	$54.73	$151.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $108.11 / $125.34 / $208.15	Professional	TC	$108.11	$125.34	$208.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $336.85 / $411.90 / $514.87	Professional		$336.85	$411.90	$514.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.04 / $127.21 / $159.02	Professional	26	$104.04	$127.21	$159.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $232.82 / $284.68 / $355.85	Professional	TC	$232.82	$284.68	$355.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.67 / $237.22 / $402.03	Professional		$168.67	$237.22	$402.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.29 / $106.43 / $141.35	Professional	26	$65.29	$106.43	$141.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $145.44 / $218.16 / $257.43	Professional	TC	$145.44	$218.16	$257.43
Midlands Facility/Professional Professional Modifier Low / Median / High Price $341.17 / $402.03 / $472.67	Professional		$341.17	$402.03	$472.67
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $215.82 / $291.83 / $340.92	Professional		$215.82	$291.83	$340.92
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $72.33 / $94.19 / $107.39	Professional	26	$72.33	$94.19	$107.39
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $143.30 / $197.03 / $233.53	Professional	TC	$143.30	$197.03	$233.53
United Facility/Professional Professional Modifier Low / Median / High Price $209.71 / $237.22 / $363.88	Professional		$209.71	$237.22	$363.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.29 / $70.95 / $118.70	Professional	26	$65.29	$70.95	$118.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.81 / $147.11 / $245.18	Professional	TC	$143.81	$147.11	$245.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $300.89 / $354.00 / $354.00	Professional		$300.89	$354.00	$354.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $94.80 / $111.50 / $111.50	Professional	26	$94.80	$111.50	$111.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $206.10 / $242.50 / $242.50	Professional	TC	$206.10	$242.50	$242.50