Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $138.04	Facility	26	$89.13	$89.13	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $371.54 / $602.56	Professional		$213.80	$371.54	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $147.91 / $338.84	Professional	26	$77.62	$147.91	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $199.53 / $363.08	Professional	TC	$138.04	$199.53	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $630.96	Professional		$446.68	$501.19	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $173.78 / $218.78	Professional	26	$158.49	$173.78	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $323.59 / $407.38	Professional	TC	$275.42	$323.59	$407.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $436.52 / $2,398.83	Professional		$234.42	$436.52	$2,398.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $154.88 / $524.81	Professional	26	$93.33	$154.88	$524.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $309.03 / $977.24	Professional	TC	$177.83	$309.03	$977.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $537.03	Professional		$446.68	$446.68	$537.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $169.82 / $190.55	Professional	26	$169.82	$169.82	$190.55
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $275.42 / $354.81	Professional	TC	$275.42	$275.42	$354.81
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $436.52 / $501.19	Professional		$281.84	$436.52	$501.19
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $141.25 / $173.78	Professional	26	$97.72	$141.25	$173.78
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $288.40 / $323.59	Professional	TC	$177.83	$288.40	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $426.58 / $588.84	Professional		$257.04	$426.58	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $154.88 / $223.87	Professional	26	$89.13	$154.88	$223.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $269.15 / $407.38	Professional	TC	$165.96	$269.15	$407.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $537.03 / $562.34	Professional		$457.09	$537.03	$562.34
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $190.55 / $199.53	Professional	26	$162.18	$190.55	$199.53
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $346.74 / $363.08	Professional	TC	$295.12	$346.74	$363.08