Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.53 / $1,258.84 / $1,569.60	Facility		$211.53	$1,258.84	$1,569.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.18 / $35.18 / $35.18	Facility	26	$35.18	$35.18	$35.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $176.35 / $176.35 / $176.35	Facility	TC	$176.35	$176.35	$176.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.44 / $211.53 / $387.68	Professional		$190.44	$211.53	$387.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.09 / $32.68 / $152.66	Professional	26	$30.09	$32.68	$152.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $226.29 / $1,181.70	Professional	TC	$162.49	$226.29	$1,181.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.62 / $394.03 / $487.66	Professional		$316.62	$394.03	$487.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.24 / $66.26 / $82.00	Professional	26	$53.24	$66.26	$82.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.38 / $327.77 / $405.65	Professional	TC	$263.38	$327.77	$405.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $273.57 / $332.24 / $521.80	Facility		$273.57	$332.24	$521.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $218.37 / $368.12 / $1,578.90	Professional		$218.37	$368.12	$1,578.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $68.45 / $889.65	Professional	26	$37.65	$68.45	$889.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $180.72 / $328.58 / $1,388.59	Professional	TC	$180.72	$328.58	$1,388.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $347.19 / $407.80 / $478.36	Facility		$347.19	$407.80	$478.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $286.82 / $368.12 / $478.36	Professional		$286.82	$368.12	$478.36
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $229.28 / $313.77 / $358.15	Professional		$229.28	$313.77	$358.15
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $54.47 / $62.10	Professional	26	$41.11	$54.47	$62.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $182.32 / $259.30 / $296.02	Professional	TC	$182.32	$259.30	$296.02
United Facility/Professional Professional Modifier Low / Median / High Price $218.37 / $351.70 / $413.76	Professional		$218.37	$351.70	$413.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $60.69 / $71.40	Professional	26	$37.65	$60.69	$71.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.72 / $291.01 / $342.36	Professional	TC	$180.72	$291.01	$342.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $340.80 / $400.90 / $417.00	Professional		$340.80	$400.90	$417.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $59.20 / $69.59 / $72.40	Professional	26	$59.20	$69.59	$72.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $281.60 / $331.30 / $344.60	Professional	TC	$281.60	$331.30	$344.60