Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.22 / $49.22 / $49.22	Facility	26	$49.22	$49.22	$49.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $227.30 / $349.23	Professional		$206.63	$227.30	$349.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $45.57 / $70.01	Professional	26	$44.14	$45.57	$70.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $178.73 / $258.72	Professional	TC	$162.49	$178.73	$258.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.79 / $544.36 / $680.45	Professional		$441.79	$544.36	$680.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.76 / $93.04 / $115.15	Professional	26	$74.76	$93.04	$115.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $367.03 / $452.24 / $565.29	Professional	TC	$367.03	$452.24	$565.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $306.41 / $512.42 / $1,904.10	Professional		$306.41	$512.42	$1,904.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.47 / $93.58 / $588.72	Professional	26	$51.47	$93.58	$588.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $254.94 / $463.52 / $1,640.58	Professional	TC	$254.94	$463.52	$1,640.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $321.00 / $461.18 / $582.88	Professional		$321.00	$461.18	$582.88
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $320.69 / $435.76 / $512.83	Professional		$320.69	$435.76	$512.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $56.53 / $76.03 / $86.68	Professional	26	$56.53	$76.03	$86.68
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $269.94 / $359.73 / $427.88	Professional	TC	$269.94	$359.73	$427.88
United Facility/Professional Professional Modifier Low / Median / High Price $306.41 / $492.78 / $579.75	Professional		$306.41	$492.78	$579.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.47 / $84.52 / $99.44	Professional	26	$51.47	$84.52	$99.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $254.94 / $408.26 / $480.31	Professional	TC	$254.94	$408.26	$480.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $473.30 / $556.79 / $579.10	Professional		$473.30	$556.79	$579.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $82.60 / $97.20 / $101.00	Professional	26	$82.60	$97.20	$101.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $390.70 / $459.60 / $478.00	Professional	TC	$390.70	$459.60	$478.00