Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $548.29 / $1,292.33 / $2,721.11	Facility		$548.29	$1,292.33	$2,721.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.28 / $327.57 / $327.57	Facility	26	$74.28	$327.57	$327.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.24 / $239.34 / $703.80	Professional		$191.24	$239.34	$703.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.54 / $68.20 / $259.31	Professional	26	$64.54	$68.20	$259.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.09 / $192.63 / $981.00	Professional	TC	$118.09	$192.63	$981.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.91 / $413.06 / $511.21	Professional		$331.91	$413.06	$511.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.28 / $141.60 / $174.48	Professional	26	$113.28	$141.60	$174.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.63 / $271.73 / $336.74	Professional	TC	$218.63	$271.73	$336.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $287.66 / $400.50 / $2,268.21	Facility		$287.66	$400.50	$2,268.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $252.96 / $395.09 / $3,949.29	Professional		$252.96	$395.09	$3,949.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.26 / $133.07 / $433.24	Professional	26	$70.26	$133.07	$433.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $182.70 / $285.52 / $1,005.74	Professional	TC	$182.70	$285.52	$1,005.74
Midlands Facility/Professional Facility Modifier Low / Median / High Price $369.19 / $452.51 / $543.11	Facility		$369.19	$452.51	$543.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $334.77 / $395.09 / $543.11	Professional		$334.77	$395.09	$543.11
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $252.56 / $357.08 / $377.54	Professional		$252.56	$357.08	$377.54
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.95 / $105.59 / $130.66	Professional	26	$77.95	$105.59	$130.66
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $167.09 / $232.93 / $275.24	Professional	TC	$167.09	$232.93	$275.24
United Facility/Professional Professional Modifier Low / Median / High Price $252.96 / $374.65 / $459.92	Professional		$252.96	$374.65	$459.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.19 / $131.97 / $186.51	Professional	26	$79.19	$131.97	$186.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.47 / $257.64 / $359.34	Professional	TC	$167.47	$257.64	$359.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $387.70 / $456.10 / $474.30	Professional		$387.70	$456.10	$474.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $134.80 / $158.60 / $164.90	Professional	26	$134.80	$158.60	$164.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $252.90 / $297.50 / $309.39	Professional	TC	$252.90	$297.50	$309.39