Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.28 / $74.28 / $74.28	Facility	26	$74.28	$74.28	$74.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.15 / $214.53 / $333.12	Professional		$189.15	$214.53	$333.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.44 / $79.45 / $269.10	Professional	26	$66.44	$79.45	$269.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.95 / $142.30 / $220.68	Professional	TC	$120.95	$142.30	$220.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.22 / $389.80 / $482.42	Professional		$313.22	$389.80	$482.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.28 / $140.97 / $174.48	Professional	26	$113.28	$140.97	$174.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.94 / $248.82 / $307.95	Professional	TC	$199.94	$248.82	$307.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $242.52 / $402.86 / $1,677.02	Professional		$242.52	$402.86	$1,677.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $78.55 / $142.82 / $718.23	Professional	26	$78.55	$142.82	$718.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $174.59 / $252.16 / $985.97	Professional	TC	$174.59	$252.16	$985.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $268.00 / $360.01 / $480.71	Professional		$268.00	$360.01	$480.71
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $218.47 / $310.37 / $393.38	Professional		$218.47	$310.37	$393.38
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $86.66 / $114.61 / $130.66	Professional	26	$86.66	$114.61	$130.66
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $139.10 / $204.23 / $276.18	Professional	TC	$139.10	$204.23	$276.18
United Facility/Professional Professional Modifier Low / Median / High Price $232.75 / $345.31 / $485.04	Professional		$232.75	$345.31	$485.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.55 / $129.16 / $150.69	Professional	26	$78.55	$129.16	$150.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.85 / $216.14 / $342.22	Professional	TC	$141.85	$216.14	$342.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $365.00 / $429.40 / $446.60	Professional		$365.00	$429.40	$446.60
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 $230.20 / $270.80 / $281.70	Professional	TC	$230.20	$270.80	$281.70