Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $295.12 / $416.87	Professional		$204.17	$295.12	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $38.90 / $63.10	Professional	26	$33.11	$38.90	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $251.19 / $354.81	Professional	TC	$165.96	$251.19	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $501.19 / $758.58	Professional		$363.08	$501.19	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $109.65	Professional	26	$52.48	$72.44	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $426.58 / $645.65	Professional	TC	$309.03	$426.58	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $316.23 / $2,089.30	Professional		$208.93	$316.23	$2,089.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $44.67 / $269.15	Professional	26	$27.54	$44.67	$269.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $275.42 / $1,819.70	Professional	TC	$181.97	$275.42	$1,819.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $562.34 / $562.34	Professional		$478.63	$562.34	$562.34
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $81.28 / $81.28	Professional	26	$70.79	$81.28	$81.28
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $478.63 / $478.63	Professional	TC	$407.38	$478.63	$478.63
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $501.19 / $575.44	Professional		$331.13	$501.19	$575.44
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $74.13 / $77.62	Professional	26	$58.88	$74.13	$77.62
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $426.58 / $501.19	Professional	TC	$263.03	$426.58	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $691.83	Professional		$173.78	$275.42	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.31 / $91.20	Professional	26	$24.55	$36.31	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $239.88 / $588.84	Professional	TC	$147.91	$239.88	$588.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $602.56 / $645.65	Professional		$467.74	$602.56	$645.65
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $95.50	Professional	26	$69.18	$89.13	$95.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $512.86 / $549.54	Professional	TC	$398.11	$512.86	$549.54