Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.39 / $629.14 / $731.70	Facility		$168.39	$629.14	$731.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.96 / $43.96 / $43.96	Facility	26	$43.96	$43.96	$43.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.83 / $211.81 / $284.93	Professional		$138.83	$211.81	$284.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.96 / $73.23 / $142.63	Professional	26	$43.96	$73.23	$142.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.59 / $156.36 / $251.80	Professional	TC	$116.59	$156.36	$251.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.48 / $314.01 / $355.08	Professional		$283.48	$314.01	$355.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.25 / $81.61 / $98.01	Professional	26	$78.25	$81.61	$98.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.76 / $232.40 / $236.43	Professional	TC	$188.76	$232.40	$236.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.53 / $234.62 / $409.71	Facility		$123.53	$234.62	$409.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $179.58 / $321.86 / $1,023.12	Professional		$179.58	$321.86	$1,023.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $75.42 / $261.30	Professional	26	$40.47	$75.42	$261.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $127.55 / $255.10 / $767.60	Professional	TC	$127.55	$255.10	$767.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $261.58 / $337.80 / $419.72	Facility		$261.58	$337.80	$419.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $261.58 / $337.80 / $419.72	Professional		$261.58	$337.80	$419.72
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $164.32 / $218.45 / $294.16	Professional		$164.32	$218.45	$294.16
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.72 / $63.74 / $85.40	Professional	26	$46.72	$63.74	$85.40
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $117.60 / $154.46 / $208.87	Professional	TC	$117.60	$154.46	$208.87
United Facility/Professional Professional Modifier Low / Median / High Price $179.58 / $299.86 / $377.12	Professional		$179.58	$299.86	$377.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.03 / $75.42 / $108.27	Professional	26	$52.03	$75.42	$108.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.55 / $225.07 / $267.86	Professional	TC	$127.55	$225.07	$267.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $256.89 / $314.30 / $314.30	Professional		$256.89	$314.30	$314.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $76.70 / $93.90 / $93.90	Professional	26	$76.70	$93.90	$93.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $180.20 / $220.40 / $220.40	Professional	TC	$180.20	$220.40	$220.40