Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	26	$50.12	$50.12	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $389.05 / $870.96	Professional		$354.81	$389.05	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $75.86 / $234.42	Professional	26	$47.86	$75.86	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $338.84 / $741.31	Professional	TC	$309.03	$338.84	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $812.83 / $1,023.29	Professional		$660.69	$812.83	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $114.82 / $144.54	Professional	26	$93.33	$114.82	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $707.95 / $870.96	Professional	TC	$575.44	$707.95	$870.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $467.74 / $776.25	Professional		$338.84	$467.74	$776.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $67.61 / $125.89	Professional	26	$45.71	$67.61	$125.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $416.87 / $870.96	Professional	TC	$295.12	$416.87	$870.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Professional		$776.25	$776.25	$776.25
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	26	$120.23	$120.23	$120.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $645.65 / $645.65	Professional	TC	$645.65	$645.65	$645.65
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $575.44 / $660.69	Professional		$426.58	$575.44	$660.69
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $85.11 / $95.50	Professional	26	$67.61	$85.11	$95.50
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $489.78 / $562.34	Professional	TC	$363.08	$489.78	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $588.84 / $776.25	Professional		$389.05	$588.84	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $109.65	Professional	26	$57.54	$89.13	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $501.19 / $660.69	Professional	TC	$338.84	$501.19	$660.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $676.08 / $676.08	Professional		$575.44	$676.08	$676.08
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $100.00 / $100.00	Professional	26	$85.11	$100.00	$100.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $575.44 / $575.44	Professional	TC	$489.78	$575.44	$575.44