Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.00 / $92.00 / $92.00	Facility	26	$92.00	$92.00	$92.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.98 / $402.57 / $755.46	Professional		$365.98	$402.57	$755.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $92.00 / $243.20	Professional	26	$81.31	$92.00	$243.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $284.67 / $314.55 / $623.53	Professional	TC	$284.67	$314.55	$623.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $765.21 / $942.86 / $1,178.58	Professional		$765.21	$942.86	$1,178.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $149.03 / $175.51 / $217.22	Professional	26	$149.03	$175.51	$217.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $624.16 / $769.09 / $961.36	Professional	TC	$624.16	$769.09	$961.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $411.19 / $764.72 / $2,747.80	Professional		$411.19	$764.72	$2,747.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.54 / $181.14 / $774.69	Professional	26	$87.54	$181.14	$774.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $324.14 / $648.28 / $2,208.88	Professional	TC	$324.14	$648.28	$2,208.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $570.64 / $835.35 / $1,037.94	Professional		$570.64	$835.35	$1,037.94
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $434.43 / $718.57 / $859.73	Professional		$434.43	$718.57	$859.73
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $98.02 / $138.02 / $162.37	Professional	26	$98.02	$138.02	$162.37
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $349.72 / $582.41 / $697.36	Professional	TC	$349.72	$582.41	$697.36
United Facility/Professional Professional Modifier Low / Median / High Price $411.19 / $738.76 / $1,027.98	Professional		$411.19	$738.76	$1,027.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.05 / $157.15 / $184.89	Professional	26	$87.05	$157.15	$184.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $324.14 / $551.03 / $717.68	Professional	TC	$324.14	$551.03	$717.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $886.80 / $1,085.00 / $1,085.00	Professional		$886.80	$1,085.00	$1,085.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $167.50 / $204.90 / $204.90	Professional	26	$167.50	$204.90	$204.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $719.30 / $880.10 / $880.10	Professional	TC	$719.30	$880.10	$880.10