Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.88 / $38.88 / $38.88	Facility	26	$38.88	$38.88	$38.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.36 / $273.08 / $417.48	Professional		$251.36	$273.08	$417.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.51 / $36.10 / $56.38	Professional	26	$35.51	$36.10	$56.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $215.84 / $236.99 / $361.09	Professional	TC	$215.84	$236.99	$361.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $420.27 / $523.02 / $647.29	Professional		$420.27	$523.02	$647.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.47 / $74.34 / $91.60	Professional	26	$59.47	$74.34	$91.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $360.80 / $449.01 / $555.70	Professional	TC	$360.80	$449.01	$555.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $294.39 / $516.54 / $1,627.28	Professional		$294.39	$516.54	$1,627.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $75.04 / $234.31	Professional	26	$41.27	$75.04	$234.31
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $253.13 / $460.24 / $1,392.98	Professional	TC	$253.13	$460.24	$1,392.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $516.54 / $543.99 / $662.76	Professional		$516.54	$543.99	$662.76
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $322.89 / $418.74 / $477.41	Professional		$322.89	$418.74	$477.41
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.90 / $64.12 / $73.09	Professional	26	$46.90	$64.12	$73.09
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $274.29 / $354.63 / $404.31	Professional	TC	$274.29	$354.63	$404.31
United Facility/Professional Professional Modifier Low / Median / High Price $299.62 / $480.20 / $564.94	Professional		$299.62	$480.20	$564.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $67.20 / $79.06	Professional	26	$41.27	$67.20	$79.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.13 / $412.99 / $485.87	Professional	TC	$253.13	$412.99	$485.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $454.80 / $535.00 / $556.50	Professional		$454.80	$535.00	$556.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $69.59 / $81.90 / $85.20	Professional	26	$69.59	$81.90	$85.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $385.20 / $453.10 / $471.30	Professional	TC	$385.20	$453.10	$471.30