Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.69 / $68.69 / $68.69	Facility	26	$68.69	$68.69	$68.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.06 / $500.12 / $725.20	Professional		$393.06	$500.12	$725.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.67 / $73.54 / $216.00	Professional	26	$64.67	$73.54	$216.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $334.21 / $433.27 / $622.12	Professional	TC	$334.21	$433.27	$622.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $822.15 / $1,005.31 / $1,256.63	Professional		$822.15	$1,005.31	$1,256.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.97 / $152.81 / $191.02	Professional	26	$124.97	$152.81	$191.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $697.18 / $852.49 / $1,065.61	Professional	TC	$697.18	$852.49	$1,065.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $431.61 / $654.12 / $1,426.63	Professional		$431.61	$654.12	$1,426.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.17 / $130.05 / $151.01	Professional	26	$81.17	$130.05	$151.01
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $478.67 / $779.44 / $904.39	Professional	TC	$478.67	$779.44	$904.39
Midlands Facility/Professional Professional Modifier Low / Median / High Price $842.66 / $1,116.93 / $1,667.93	Professional		$842.66	$1,116.93	$1,667.93
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $581.13 / $723.44 / $848.79	Professional		$581.13	$723.44	$848.79
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $86.80 / $112.91 / $128.72	Professional	26	$86.80	$112.91	$128.72
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $494.33 / $610.52 / $722.01	Professional	TC	$494.33	$610.52	$722.01
United Facility/Professional Professional Modifier Low / Median / High Price $431.61 / $934.75 / $1,055.40	Professional		$431.61	$934.75	$1,055.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.09 / $93.91 / $143.82	Professional	26	$79.09	$93.91	$143.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $442.19 / $519.62 / $861.32	Professional	TC	$442.19	$519.62	$861.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $728.00 / $856.40 / $856.40	Professional		$728.00	$856.40	$856.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $113.60 / $133.69 / $133.69	Professional	26	$113.60	$133.69	$133.69
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $614.29 / $722.70 / $722.70	Professional	TC	$614.29	$722.70	$722.70