Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.35 / $63.35 / $63.35	Facility	26	$63.35	$63.35	$63.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.75 / $167.68 / $277.89	Professional		$155.75	$167.68	$277.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $58.39 / $76.67	Professional	26	$53.70	$58.39	$76.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.06 / $109.29 / $161.05	Professional	TC	$102.06	$109.29	$161.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $468.14 / $621.13 / $776.41	Professional		$468.14	$621.13	$776.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.85 / $120.53 / $149.18	Professional	26	$96.85	$120.53	$149.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $378.19 / $501.79 / $627.24	Professional	TC	$378.19	$501.79	$627.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $324.33 / $597.13 / $1,731.57	Professional		$324.33	$597.13	$1,731.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.36 / $118.84 / $367.94	Professional	26	$65.36	$118.84	$367.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $299.55 / $536.65 / $1,410.54	Professional	TC	$299.55	$536.65	$1,410.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $251.09 / $324.33 / $415.55	Professional		$251.09	$324.33	$415.55
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $323.27 / $497.61 / $567.33	Professional		$323.27	$497.61	$567.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $69.92 / $95.52 / $111.91	Professional	26	$69.92	$95.52	$111.91
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $264.66 / $399.45 / $463.66	Professional	TC	$264.66	$399.45	$463.66
United Facility/Professional Professional Modifier Low / Median / High Price $364.91 / $567.79 / $663.48	Professional		$364.91	$567.79	$663.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.36 / $115.84 / $125.77	Professional	26	$65.36	$115.84	$125.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $299.55 / $459.99 / $544.64	Professional	TC	$299.55	$459.99	$544.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $540.50 / $635.79 / $661.30	Professional		$540.50	$635.79	$661.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $106.60 / $125.40 / $130.40	Professional	26	$106.60	$125.40	$130.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $433.80 / $510.40 / $530.79	Professional	TC	$433.80	$510.40	$530.79