Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.06 / $177.06 / $177.06	Professional		$177.06	$177.06	$177.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.35 / $98.35 / $98.35	Professional	26	$98.35	$98.35	$98.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.70 / $78.70 / $78.70	Professional	TC	$78.70	$78.70	$78.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.19 / $394.39 / $628.30	Professional		$137.19	$394.39	$628.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.20 / $205.52 / $311.08	Professional	26	$102.20	$205.52	$311.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.00 / $196.65 / $317.23	Professional	TC	$35.00	$196.65	$317.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.85 / $394.39 / $1,548.81	Professional		$142.85	$394.39	$1,548.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.65 / $223.24 / $832.85	Professional	26	$79.65	$223.24	$832.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $63.20 / $155.80 / $785.37	Professional	TC	$63.20	$155.80	$785.37
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $340.85 / $340.85 / $340.85	Facility	26	$340.85	$340.85	$340.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $394.39 / $412.22 / $546.07	Professional		$394.39	$412.22	$546.07
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $254.52 / $391.69 / $458.01	Professional		$254.52	$391.69	$458.01
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $149.87 / $198.43 / $228.36	Professional	26	$149.87	$198.43	$228.36
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $104.65 / $201.43 / $229.65	Professional	TC	$104.65	$201.43	$229.65
United Facility/Professional Professional Modifier Low / Median / High Price $141.01 / $142.85 / $421.16	Professional		$141.01	$142.85	$421.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.91 / $79.65 / $248.04	Professional	26	$70.91	$79.65	$248.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.20 / $70.09 / $173.12	Professional	TC	$63.20	$70.09	$173.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $401.70 / $516.90 / $555.79	Professional		$401.70	$516.90	$555.79
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $200.30 / $257.70 / $277.10	Professional	26	$200.30	$257.70	$277.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $201.40 / $259.20 / $278.70	Professional	TC	$201.40	$259.20	$278.70