Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.31 / $1,105.88 / $1,218.18	Facility		$201.31	$1,105.88	$1,218.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.39 / $39.39 / $39.39	Facility	26	$39.39	$39.39	$39.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.73 / $193.33 / $302.11	Professional		$182.73	$193.33	$302.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $36.28 / $205.20	Professional	26	$30.82	$36.28	$205.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.44 / $162.49 / $246.73	Professional	TC	$146.44	$162.49	$246.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.29 / $376.17 / $470.21	Professional		$305.29	$376.17	$470.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.60 / $74.68 / $93.34	Professional	26	$60.60	$74.68	$93.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.68 / $301.49 / $376.87	Professional	TC	$244.68	$301.49	$376.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $260.66 / $315.14 / $432.14	Facility		$260.66	$315.14	$432.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $210.55 / $355.52 / $1,459.71	Professional		$210.55	$355.52	$1,459.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.46 / $77.20 / $361.59	Professional	26	$42.46	$77.20	$361.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $168.09 / $305.62 / $1,274.61	Professional	TC	$168.09	$305.62	$1,274.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $333.74 / $392.67 / $460.42	Facility		$333.74	$392.67	$460.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $272.00 / $355.52 / $460.42	Professional		$272.00	$355.52	$460.42
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $215.34 / $305.26 / $348.03	Professional		$215.34	$305.26	$348.03
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.38 / $63.49 / $73.75	Professional	26	$42.38	$63.49	$73.75
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $168.94 / $240.58 / $274.29	Professional	TC	$168.94	$240.58	$274.29
United Facility/Professional Professional Modifier Low / Median / High Price $210.55 / $341.08 / $397.93	Professional		$210.55	$341.08	$397.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.46 / $68.48 / $80.58	Professional	26	$42.46	$68.48	$80.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.09 / $269.75 / $317.35	Professional	TC	$168.09	$269.75	$317.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $331.50 / $390.10 / $405.70	Professional		$331.50	$390.10	$405.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $70.30 / $82.60 / $86.00	Professional	26	$70.30	$82.60	$86.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $261.30 / $307.39 / $319.70	Professional	TC	$261.30	$307.39	$319.70