Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $512.86 / $1,096.48	Professional		$457.09	$512.86	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $89.13 / $213.80	Professional	26	$63.10	$89.13	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $436.52 / $933.25	Professional	TC	$380.19	$436.52	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,023.29 / $1,288.25	Professional		$831.76	$1,023.29	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $154.88 / $194.98	Professional	26	$125.89	$154.88	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $870.96 / $1,096.48	Professional	TC	$707.95	$870.96	$1,096.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $660.69 / $1,412.54	Professional		$436.52	$660.69	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $93.33 / $199.53	Professional	26	$63.10	$93.33	$199.53
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $562.34 / $1,230.27	Professional	TC	$371.54	$562.34	$1,230.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Professional	26	$251.19	$251.19	$251.19
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Professional	TC	$1,412.54	$1,412.54	$1,412.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $912.01	Professional		$575.44	$724.44	$912.01
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $128.82 / $128.82	Professional	26	$91.20	$128.82	$128.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $691.83 / $691.83	Professional	TC	$512.86	$691.83	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $741.31 / $1,047.13	Professional		$524.81	$741.31	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $112.20 / $151.36	Professional	26	$79.43	$112.20	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $630.96 / $912.01	Professional	TC	$446.68	$630.96	$912.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $851.14 / $851.14	Professional		$724.44	$851.14	$851.14
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $134.90 / $134.90	Professional	26	$114.82	$134.90	$134.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $724.44 / $724.44	Professional	TC	$616.60	$724.44	$724.44