Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $270.33 / $1,314.87 / $1,574.40	Facility		$270.33	$1,314.87	$1,574.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.67 / $39.67 / $39.67	Facility	26	$39.67	$39.67	$39.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $230.67 / $230.67 / $645.30	Facility	TC	$230.67	$230.67	$645.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $241.83 / $401.81	Professional		$189.31	$241.83	$401.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $35.97 / $199.36	Professional	26	$26.96	$35.97	$199.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $208.30 / $566.92	Professional	TC	$162.34	$208.30	$566.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.54 / $499.70 / $624.62	Professional		$405.54	$499.70	$624.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.60 / $75.42 / $93.34	Professional	26	$60.60	$75.42	$93.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $344.94 / $425.02 / $531.28	Professional	TC	$344.94	$425.02	$531.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $318.80 / $417.65 / $546.16	Facility		$318.80	$417.65	$546.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $287.45 / $482.92 / $1,952.19	Professional		$287.45	$482.92	$1,952.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.78 / $77.78 / $399.57	Professional	26	$42.78	$77.78	$399.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $244.68 / $444.88 / $1,791.16	Professional	TC	$244.68	$444.88	$1,791.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $376.96 / $525.25 / $620.91	Facility		$376.96	$525.25	$620.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $305.00 / $457.96 / $620.91	Professional		$305.00	$457.96	$620.91
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $283.30 / $401.72 / $458.01	Professional		$283.30	$401.72	$458.01
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $62.41 / $71.16	Professional	26	$42.21	$62.41	$71.16
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $239.69 / $339.31 / $386.85	Professional	TC	$239.69	$339.31	$386.85
United Facility/Professional Professional Modifier Low / Median / High Price $287.45 / $458.23 / $539.09	Professional		$287.45	$458.23	$539.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.78 / $69.06 / $81.25	Professional	26	$42.78	$69.06	$81.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.68 / $392.44 / $457.84	Professional	TC	$244.68	$392.44	$457.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $436.30 / $513.29 / $533.79	Professional		$436.30	$513.29	$533.79
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $67.80 / $79.80 / $82.90	Professional	26	$67.80	$79.80	$82.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $368.50 / $433.60 / $450.90	Professional	TC	$368.50	$433.60	$450.90