Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.52 / $143.52 / $143.52	Professional		$143.52	$143.52	$143.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.69 / $18.69 / $18.69	Professional	26	$18.69	$18.69	$18.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.84 / $124.84 / $124.84	Professional	TC	$124.84	$124.84	$124.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.99 / $339.44 / $520.22	Professional		$257.99	$339.44	$520.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.20 / $39.60 / $58.88	Professional	26	$29.20	$39.60	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.27 / $299.83 / $461.34	Professional	TC	$216.27	$299.83	$461.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.96 / $244.90 / $1,336.58	Professional		$97.96	$244.90	$1,336.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.46 / $46.76 / $315.72	Professional	26	$15.46	$46.76	$315.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.18 / $173.65 / $1,188.97	Professional	TC	$77.18	$173.65	$1,188.97
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $136.22 / $136.22 / $136.22	Facility	26	$136.22	$136.22	$136.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $262.95 / $339.44 / $413.98	Professional		$262.95	$339.44	$413.98
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $199.06 / $281.18 / $377.14	Professional		$199.06	$281.18	$377.14
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.44 / $42.35 / $79.37	Professional	26	$31.44	$42.35	$79.37
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $139.16 / $238.23 / $333.15	Professional	TC	$139.16	$238.23	$333.15
United Facility/Professional Professional Modifier Low / Median / High Price $109.24 / $120.64 / $244.90	Professional		$109.24	$120.64	$244.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.59 / $15.46 / $46.76	Professional	26	$13.59	$15.46	$46.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.78 / $107.05 / $173.65	Professional	TC	$93.78	$107.05	$173.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $330.80 / $425.60 / $457.70	Professional		$330.80	$425.60	$457.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.60 / $49.60 / $53.40	Professional	26	$38.60	$49.60	$53.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $292.20 / $376.00 / $404.30	Professional	TC	$292.20	$376.00	$404.30