Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.61 / $98.61 / $98.61	Facility	26	$98.61	$98.61	$98.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $743.25 / $944.35 / $1,371.59	Professional		$743.25	$944.35	$1,371.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.34 / $98.61 / $263.44	Professional	26	$84.34	$98.61	$263.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $658.90 / $849.37 / $1,223.50	Professional	TC	$658.90	$849.37	$1,223.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,549.78 / $1,895.04 / $2,368.79	Professional		$1,549.78	$1,895.04	$2,368.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $178.89 / $218.75 / $273.43	Professional	26	$178.89	$218.75	$273.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,370.88 / $1,676.29 / $2,095.36	Professional	TC	$1,370.88	$1,676.29	$2,095.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $812.30 / $1,231.63 / $2,687.89	Professional		$812.30	$1,231.63	$2,687.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $115.39 / $184.70 / $214.45	Professional	26	$115.39	$184.70	$214.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $938.24 / $1,528.09 / $1,773.03	Professional	TC	$938.24	$1,528.09	$1,773.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,580.38 / $2,112.54 / $3,133.22	Professional		$1,580.38	$2,112.54	$3,133.22
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,099.76 / $1,363.46 / $1,606.30	Professional		$1,099.76	$1,363.46	$1,606.30
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $124.99 / $162.28 / $185.01	Professional	26	$124.99	$162.28	$185.01
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $974.76 / $1,201.19 / $1,423.74	Professional	TC	$974.76	$1,201.19	$1,423.74
United Facility/Professional Professional Modifier Low / Median / High Price $812.30 / $1,135.70 / $1,892.84	Professional		$812.30	$1,135.70	$1,892.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $113.45 / $123.13 / $204.24	Professional	26	$113.45	$123.13	$204.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $871.59 / $1,293.30 / $1,773.03	Professional	TC	$871.59	$1,293.30	$1,773.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,372.00 / $1,614.10 / $1,614.10	Professional		$1,372.00	$1,614.10	$1,614.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $163.30 / $192.10 / $192.10	Professional	26	$163.30	$192.10	$192.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $1,208.70 / $1,422.00 / $1,422.00	Professional	TC	$1,208.70	$1,422.00	$1,422.00