Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.52 / $133.52 / $133.52	Facility	26	$133.52	$133.52	$133.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $665.47 / $777.87 / $1,597.10	Professional		$665.47	$777.87	$1,597.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.65 / $223.37 / $479.56	Professional	26	$121.65	$223.37	$479.56
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $297.79 / $332.74 / $359.49	Professional	52	$297.79	$332.74	$359.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $543.82 / $654.21 / $992.17	Professional	TC	$543.82	$654.21	$992.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,368.68 / $1,371.47 / $1,714.34	Professional		$1,368.68	$1,371.47	$1,714.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $245.04 / $247.50 / $306.93	Professional	26	$245.04	$247.50	$306.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,123.64 / $1,125.93 / $1,407.41	Professional	TC	$1,123.64	$1,125.93	$1,407.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $658.45 / $1,217.29 / $6,200.00	Professional		$658.45	$1,217.29	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $139.25 / $240.14 / $1,081.48	Professional	26	$139.25	$240.14	$1,081.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $531.86 / $1,063.72 / $3,875.48	Professional	TC	$531.86	$1,063.72	$3,875.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,031.92 / $1,297.78 / $1,656.78	Professional		$1,031.92	$1,297.78	$1,656.78
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $772.22 / $1,072.80 / $1,274.39	Professional		$772.22	$1,072.80	$1,274.39
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $145.38 / $205.40 / $234.18	Professional	26	$145.38	$205.40	$234.18
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $625.82 / $859.28 / $1,040.22	Professional	TC	$625.82	$859.28	$1,040.22
United Facility/Professional Professional Modifier Low / Median / High Price $658.45 / $1,150.13 / $1,646.13	Professional		$658.45	$1,150.13	$1,646.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $126.59 / $226.96 / $267.02	Professional	26	$126.59	$226.96	$267.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $531.86 / $923.17 / $1,218.94	Professional	TC	$531.86	$923.17	$1,218.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,314.50 / $1,608.30 / $1,608.30	Professional		$1,314.50	$1,608.30	$1,608.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $241.50 / $295.50 / $295.50	Professional	26	$241.50	$295.50	$295.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $1,072.90 / $1,312.80 / $1,312.80	Professional	TC	$1,072.90	$1,312.80	$1,312.80