Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.89 / $58.89 / $58.89	Facility	26	$58.89	$58.89	$58.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $271.63 / $517.14	Professional		$246.93	$271.63	$517.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.72 / $84.59 / $293.70	Professional	26	$51.72	$84.59	$293.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $566.10 / $1,146.59	Professional	TC	$162.34	$566.10	$1,146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.32 / $549.95 / $687.43	Professional		$446.32	$549.95	$687.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.92 / $110.67 / $136.96	Professional	26	$88.92	$110.67	$136.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $357.40 / $440.37 / $550.47	Professional	TC	$357.40	$440.37	$550.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $312.17 / $526.30 / $2,362.07	Professional		$312.17	$526.30	$2,362.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.45 / $119.22 / $507.12	Professional	26	$68.45	$119.22	$507.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $249.41 / $453.48 / $1,854.93	Professional	TC	$249.41	$453.48	$1,854.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $408.77 / $526.30 / $679.60	Professional		$408.77	$526.30	$679.60
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $311.58 / $443.14 / $505.85	Professional		$311.58	$443.14	$505.85
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $69.50 / $93.99 / $104.80	Professional	26	$69.50	$93.99	$104.80
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $247.94 / $351.22 / $401.89	Professional	TC	$247.94	$351.22	$401.89
United Facility/Professional Professional Modifier Low / Median / High Price $340.55 / $527.94 / $733.86	Professional		$340.55	$527.94	$733.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.76 / $101.33 / $119.22	Professional	26	$62.76	$101.33	$119.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.41 / $398.18 / $468.44	Professional	TC	$249.41	$398.18	$468.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $481.30 / $566.20 / $588.90	Professional		$481.30	$566.20	$588.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $99.80 / $117.50 / $122.10	Professional	26	$99.80	$117.50	$122.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $381.50 / $448.80 / $466.70	Professional	TC	$381.50	$448.80	$466.70