Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.42 / $66.42 / $66.42	Facility	26	$66.42	$66.42	$66.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $224.12 / $613.60	Professional		$215.53	$224.12	$613.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.87 / $152.19 / $322.18	Professional	26	$60.87	$152.19	$322.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $180.91 / $1,472.95	Professional	TC	$152.75	$180.91	$1,472.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.56 / $460.29 / $569.66	Professional		$373.56	$460.29	$569.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.82 / $125.47 / $155.28	Professional	26	$100.82	$125.47	$155.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $271.73 / $331.50 / $414.38	Professional	TC	$271.73	$331.50	$414.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $262.44 / $447.62 / $1,442.20	Professional		$262.44	$447.62	$1,442.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.26 / $127.74 / $507.29	Professional	26	$70.26	$127.74	$507.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $192.18 / $349.42 / $1,055.58	Professional	TC	$192.18	$349.42	$1,055.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $316.00 / $447.62 / $519.05	Professional		$316.00	$447.62	$519.05
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $268.13 / $365.97 / $417.25	Professional		$268.13	$365.97	$417.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $75.37 / $102.13 / $116.44	Professional	26	$75.37	$102.13	$116.44
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $166.00 / $263.83 / $300.81	Professional	TC	$166.00	$263.83	$300.81
United Facility/Professional Professional Modifier Low / Median / High Price $262.44 / $424.57 / $495.33	Professional		$262.44	$424.57	$495.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.26 / $114.56 / $134.78	Professional	26	$70.26	$114.56	$134.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.18 / $318.22 / $381.51	Professional	TC	$192.18	$318.22	$381.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $430.40 / $506.30 / $526.60	Professional		$430.40	$506.30	$526.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $120.10 / $141.30 / $147.00	Professional	26	$120.10	$141.30	$147.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $310.30 / $365.00 / $379.60	Professional	TC	$310.30	$365.00	$379.60