Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $205.79 / $288.00 / $1,053.00	Professional		$205.79	$288.00	$1,053.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.26 / $240.39 / $299.70	Professional	26	$62.26	$240.39	$299.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.53 / $559.80 / $756.50	Professional	TC	$143.53	$559.80	$756.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.00 / $475.02 / $766.27	Professional		$280.00	$475.02	$766.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.28 / $139.83 / $224.00	Professional	26	$103.28	$139.83	$224.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.00 / $345.92 / $558.01	Professional	TC	$56.00	$345.92	$558.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $233.55 / $329.36 / $778.89	Facility		$233.55	$329.36	$778.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.08 / $483.44 / $1,813.36	Professional		$168.08	$483.44	$1,813.36
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.56 / $156.71 / $509.36	Professional	26	$51.56	$156.71	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.52 / $326.73 / $1,303.99	Professional	TC	$116.52	$326.73	$1,303.99
Midlands Facility/Professional Facility Modifier Low / Median / High Price $332.50 / $562.66 / $671.59	Facility		$332.50	$562.66	$671.59
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $324.00 / $324.00 / $324.00	Facility	26	$324.00	$324.00	$324.00
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $303.68 / $303.68 / $303.68	Facility	TC	$303.68	$303.68	$303.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $290.00 / $463.54 / $571.05	Professional		$290.00	$463.54	$571.05
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $279.70 / $472.91 / $556.33	Professional		$279.70	$472.91	$556.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $96.89 / $134.47 / $153.32	Professional	26	$96.89	$134.47	$153.32
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $211.80 / $342.59 / $403.02	Professional	TC	$211.80	$342.59	$403.02
United Facility/Professional Professional Modifier Low / Median / High Price $168.08 / $172.56 / $537.16	Professional		$168.08	$172.56	$537.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.33 / $51.56 / $174.12	Professional	26	$47.33	$51.56	$174.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.52 / $176.47 / $380.40	Professional	TC	$116.52	$176.47	$380.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $487.90 / $627.79 / $675.10	Professional		$487.90	$627.79	$675.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $134.50 / $173.00 / $186.00	Professional	26	$134.50	$173.00	$186.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $353.50 / $454.80 / $489.10	Professional	TC	$353.50	$454.80	$489.10