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 / $89.13	Facility	26	$89.13	$89.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.51 / $252.36 / $399.33	Professional		$236.51	$252.36	$399.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.79 / $95.99 / $342.90	Professional	26	$78.79	$95.99	$342.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.81 / $165.09 / $261.02	Professional	TC	$154.81	$165.09	$261.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $393.65 / $485.04 / $606.29	Professional		$393.65	$485.04	$606.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $136.50 / $169.88 / $210.24	Professional	26	$136.50	$169.88	$210.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.14 / $316.85 / $396.06	Professional	TC	$257.14	$316.85	$396.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $285.08 / $444.84 / $2,380.40	Professional		$285.08	$444.84	$2,380.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $94.11 / $171.10 / $520.19	Professional	26	$94.11	$171.10	$520.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $206.14 / $317.62 / $982.86	Professional	TC	$206.14	$317.62	$982.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.42 / $447.00 / $634.64	Professional		$398.42	$447.00	$634.64
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $291.83 / $390.37 / $449.50	Professional		$291.83	$390.37	$449.50
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $103.84 / $137.31 / $156.55	Professional	26	$103.84	$137.31	$156.55
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $190.51 / $253.06 / $306.75	Professional	TC	$190.51	$253.06	$306.75
United Facility/Professional Professional Modifier Low / Median / High Price $300.25 / $423.44 / $545.90	Professional		$300.25	$423.44	$545.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.11 / $153.46 / $180.54	Professional	26	$94.11	$153.46	$180.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.65 / $272.25 / $374.80	Professional	TC	$178.65	$272.25	$374.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $459.10 / $540.10 / $561.70	Professional		$459.10	$540.10	$561.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $161.50 / $190.00 / $197.60	Professional	26	$161.50	$190.00	$197.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $297.60 / $350.10 / $364.10	Professional	TC	$297.60	$350.10	$364.10