Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.54 / $40.54 / $40.54	Facility	26	$40.54	$40.54	$40.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.78 / $197.07 / $386.62	Professional		$190.78	$197.07	$386.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.13 / $37.88 / $144.80	Professional	26	$31.13	$37.88	$144.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.09 / $195.45 / $1,145.70	Professional	TC	$145.09	$195.45	$1,145.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.72 / $396.41 / $495.51	Professional		$321.72	$396.41	$495.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.74 / $76.14 / $95.09	Professional	26	$61.74	$76.14	$95.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $259.98 / $320.33 / $400.42	Professional	TC	$259.98	$320.33	$400.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $224.06 / $380.32 / $1,582.03	Professional		$224.06	$380.32	$1,582.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.33 / $78.78 / $422.69	Professional	26	$43.33	$78.78	$422.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $180.73 / $328.60 / $1,414.75	Professional	TC	$180.73	$328.60	$1,414.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $256.00 / $380.32 / $492.39	Professional		$256.00	$380.32	$492.39
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $223.97 / $318.88 / $363.56	Professional		$223.97	$318.88	$363.56
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.96 / $63.55 / $72.45	Professional	26	$42.96	$63.55	$72.45
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $179.96 / $255.33 / $291.58	Professional	TC	$179.96	$255.33	$291.58
United Facility/Professional Professional Modifier Low / Median / High Price $224.06 / $360.07 / $423.61	Professional		$224.06	$360.07	$423.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.33 / $74.56 / $100.88	Professional	26	$43.33	$74.56	$100.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.73 / $289.72 / $340.85	Professional	TC	$180.73	$289.72	$340.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $346.30 / $407.40 / $423.70	Professional		$346.30	$407.40	$423.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.00 / $81.20 / $84.40	Professional	26	$69.00	$81.20	$84.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $277.30 / $326.30 / $339.30	Professional	TC	$277.30	$326.30	$339.30