Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.90 / $39.90 / $39.90	Facility	26	$39.90	$39.90	$39.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.96 / $201.33 / $333.20	Professional		$183.96	$201.33	$333.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.46 / $36.22 / $202.92	Professional	26	$21.46	$36.22	$202.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $164.62 / $275.93	Professional	TC	$162.49	$164.62	$275.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $336.44 / $414.55 / $518.19	Professional		$336.44	$414.55	$518.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.17 / $75.37 / $94.22	Professional	26	$61.17	$75.37	$94.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.27 / $339.18 / $423.97	Professional	TC	$275.27	$339.18	$423.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $230.13 / $387.84 / $1,546.49	Professional		$230.13	$387.84	$1,546.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.10 / $78.36 / $391.31	Professional	26	$43.10	$78.36	$391.31
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $187.03 / $340.06 / $1,417.87	Professional	TC	$187.03	$340.06	$1,417.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.00 / $387.84 / $425.82	Professional		$263.00	$387.84	$425.82
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $233.40 / $334.77 / $381.67	Professional		$233.40	$334.77	$381.67
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $37.95 / $63.55 / $72.45	Professional	26	$37.95	$63.55	$72.45
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $189.39 / $271.22 / $309.22	Professional	TC	$189.39	$271.22	$309.22
United Facility/Professional Professional Modifier Low / Median / High Price $251.05 / $395.46 / $455.54	Professional		$251.05	$395.46	$455.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.10 / $70.36 / $100.21	Professional	26	$43.10	$70.36	$100.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.03 / $301.30 / $354.48	Professional	TC	$204.03	$301.30	$354.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $363.60 / $427.80 / $444.90	Professional		$363.60	$427.80	$444.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.00 / $81.20 / $84.40	Professional	26	$69.00	$81.20	$84.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $294.60 / $346.60 / $360.40	Professional	TC	$294.60	$346.60	$360.40