Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $48.98 / $48.98	Facility	26	$46.77	$48.98	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $288.40 / $398.11	Professional		$234.42	$288.40	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $51.29 / $186.21	Professional	26	$40.74	$51.29	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $239.88 / $331.13	Professional	TC	$190.55	$239.88	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $707.95	Professional		$467.74	$562.34	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $95.50 / $117.49	Professional	26	$87.10	$95.50	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $467.74 / $588.84	Professional	TC	$389.05	$467.74	$588.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $501.19 / $1,905.46	Professional		$245.47	$501.19	$1,905.46
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $85.11 / $588.84	Professional	26	$47.86	$85.11	$588.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $416.87 / $1,621.81	Professional	TC	$257.04	$416.87	$1,621.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $512.86 / $512.86	Professional		$389.05	$512.86	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $93.33 / $100.00	Professional	26	$93.33	$93.33	$100.00
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $416.87 / $416.87	Professional	TC	$288.40	$416.87	$416.87
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $436.52 / $501.19	Professional		$323.59	$436.52	$501.19
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.13 / $87.10	Professional	26	$56.23	$74.13	$87.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $363.08 / $407.38	Professional	TC	$269.15	$363.08	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $489.78 / $707.95	Professional		$302.00	$489.78	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $85.11 / $102.33	Professional	26	$48.98	$85.11	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $407.38 / $602.56	Professional	TC	$251.19	$407.38	$602.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $562.34 / $575.44	Professional		$478.63	$562.34	$575.44
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $97.72 / $100.00	Professional	26	$83.18	$97.72	$100.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $457.09 / $478.63	Professional	TC	$389.05	$457.09	$478.63