Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.95 / $50.95 / $50.95	Facility	26	$50.95	$50.95	$50.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.77 / $357.47 / $577.42	Professional		$313.77	$357.47	$577.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.67 / $50.84 / $234.96	Professional	26	$47.67	$50.84	$234.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.87 / $308.92 / $500.71	Professional	TC	$269.87	$308.92	$500.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $653.41 / $798.97 / $998.71	Professional		$653.41	$798.97	$998.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.62 / $113.25 / $141.57	Professional	26	$92.62	$113.25	$141.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $560.79 / $685.72 / $857.15	Professional	TC	$560.79	$685.72	$857.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $341.12 / $478.85 / $770.49	Professional		$341.12	$478.85	$770.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.24 / $94.73 / $126.45	Professional	26	$57.24	$94.73	$126.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $334.99 / $609.08 / $640.85	Professional	TC	$334.99	$609.08	$640.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $556.00 / $770.49 / $1,036.38	Professional		$556.00	$770.49	$1,036.38
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $371.22 / $573.82 / $673.84	Professional		$371.22	$573.82	$673.84
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $63.50 / $83.98 / $95.74	Professional	26	$63.50	$83.98	$95.74
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $315.22 / $487.95 / $580.02	Professional	TC	$315.22	$487.95	$580.02
United Facility/Professional Professional Modifier Low / Median / High Price $392.23 / $709.39 / $738.22	Professional		$392.23	$709.39	$738.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.24 / $82.11 / $135.88	Professional	26	$57.24	$82.11	$135.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $334.99 / $415.69 / $640.85	Professional	TC	$334.99	$415.69	$640.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $578.90 / $681.10 / $681.10	Professional		$578.90	$681.10	$681.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $84.50 / $99.40 / $99.40	Professional	26	$84.50	$99.40	$99.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $494.40 / $581.70 / $581.70	Professional	TC	$494.40	$581.70	$581.70