Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.89 / $854.92 / $1,027.71	Facility		$113.89	$854.92	$1,027.71
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.58 / $22.58 / $22.58	Facility	26	$22.58	$22.58	$22.58
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $111.54 / $399.75 / $471.63	Facility	TC	$111.54	$399.75	$471.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.16 / $113.92 / $232.83	Professional		$20.16	$113.92	$232.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.59 / $31.85 / $98.69	Professional	26	$19.59	$31.85	$98.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.34 / $141.99 / $495.73	Professional	TC	$96.34	$141.99	$495.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.77 / $249.85 / $312.31	Professional		$202.77	$249.85	$312.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $42.48 / $52.34	Professional	26	$33.97	$42.48	$52.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.79 / $207.97 / $259.97	Professional	TC	$168.79	$207.97	$259.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $174.30 / $221.56 / $778.80	Facility		$174.30	$221.56	$778.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $133.27 / $228.15 / $1,052.95	Professional		$133.27	$228.15	$1,052.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.16 / $43.92 / $237.75	Professional	26	$24.16	$43.92	$237.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $109.11 / $198.38 / $927.48	Professional	TC	$109.11	$198.38	$927.48
Midlands Facility/Professional Facility Modifier Low / Median / High Price $221.26 / $258.68 / $290.45	Facility		$221.26	$258.68	$290.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $175.16 / $228.15 / $290.45	Professional		$175.16	$228.15	$290.45
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $147.16 / $199.01 / $229.00	Professional		$147.16	$199.01	$229.00
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.38 / $35.18 / $40.11	Professional	26	$26.38	$35.18	$40.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $119.71 / $161.88 / $188.89	Professional	TC	$119.71	$161.88	$188.89
United Facility/Professional Professional Modifier Low / Median / High Price $133.27 / $221.83 / $258.80	Professional		$133.27	$221.83	$258.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.16 / $39.36 / $46.31	Professional	26	$24.16	$39.36	$46.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.11 / $180.62 / $212.49	Professional	TC	$109.11	$180.62	$212.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $218.20 / $256.60 / $266.89	Professional		$218.20	$256.60	$266.89
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.20 / $45.00 / $46.70	Professional	26	$38.20	$45.00	$46.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $179.90 / $211.70 / $220.20	Professional	TC	$179.90	$211.70	$220.20