Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.02 / $834.16 / $1,001.34	Facility		$223.02	$834.16	$1,001.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.06 / $24.06 / $24.06	Facility	26	$24.06	$24.06	$24.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $122.82 / $189.44	Professional		$62.30	$122.82	$189.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $24.06 / $63.19	Professional	26	$18.44	$24.06	$63.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.26 / $112.49 / $334.64	Professional	TC	$102.26	$112.49	$334.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.99 / $299.39 / $374.25	Professional		$242.99	$299.39	$374.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.25 / $45.31 / $55.83	Professional	26	$36.25	$45.31	$55.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $206.74 / $254.73 / $318.42	Professional	TC	$206.74	$254.73	$318.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $187.82 / $233.02 / $345.72	Facility		$187.82	$233.02	$345.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.08 / $275.04 / $1,223.39	Professional		$168.08	$275.04	$1,223.39
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.05 / $47.36 / $237.75	Professional	26	$26.05	$47.36	$237.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $142.03 / $258.24 / $1,114.63	Professional	TC	$142.03	$258.24	$1,114.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $235.00 / $280.98 / $363.85	Facility		$235.00	$280.98	$363.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $185.00 / $253.54 / $362.70	Professional		$185.00	$253.54	$362.70
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $169.75 / $241.15 / $274.93	Professional		$169.75	$241.15	$274.93
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.00 / $38.02 / $43.34	Professional	26	$26.00	$38.02	$43.34
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $143.03 / $203.13 / $231.59	Professional	TC	$143.03	$203.13	$231.59
United Facility/Professional Professional Modifier Low / Median / High Price $168.08 / $270.27 / $320.88	Professional		$168.08	$270.27	$320.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.05 / $42.41 / $49.90	Professional	26	$26.05	$42.41	$49.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.28 / $227.87 / $268.08	Professional	TC	$133.28	$227.87	$268.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $261.89 / $308.10 / $320.50	Professional		$261.89	$308.10	$320.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.30 / $48.60 / $50.50	Professional	26	$41.30	$48.60	$50.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $220.60 / $259.60 / $269.89	Professional	TC	$220.60	$259.60	$269.89