Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.12 / $87.12 / $87.12	Facility	26	$87.12	$87.12	$87.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $159.60 / $254.57	Professional		$130.08	$159.60	$254.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.04 / $80.12 / $124.46	Professional	26	$75.04	$80.12	$124.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $63.90 / $130.10	Professional	TC	$55.03	$63.90	$130.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.30 / $327.77 / $405.65	Professional		$278.30	$327.77	$405.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.65 / $165.65 / $205.01	Professional	26	$140.65	$165.65	$205.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.66 / $162.84 / $200.65	Professional	TC	$137.66	$162.84	$200.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.40 / $331.56 / $1,053.48	Professional		$174.40	$331.56	$1,053.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $82.74 / $165.48 / $509.36	Professional	26	$82.74	$165.48	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.66 / $183.32 / $544.05	Professional	TC	$91.66	$183.32	$544.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $216.12 / $331.56 / $392.40	Professional		$216.12	$331.56	$392.40
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $162.32 / $254.05 / $298.87	Professional		$162.32	$254.05	$298.87
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $94.29 / $130.33 / $153.32	Professional	26	$94.29	$130.33	$153.32
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $82.01 / $123.73 / $153.40	Professional	TC	$82.01	$123.73	$153.40
United Facility/Professional Professional Modifier Low / Median / High Price $174.40 / $296.48 / $366.24	Professional		$174.40	$296.48	$366.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.74 / $148.78 / $175.04	Professional	26	$82.74	$148.78	$175.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.66 / $161.27 / $229.15	Professional	TC	$91.66	$161.27	$229.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $308.30 / $377.20 / $377.20	Professional		$308.30	$377.20	$377.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $158.10 / $193.50 / $193.50	Professional	26	$158.10	$193.50	$193.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $150.10 / $183.70 / $183.70	Professional	TC	$150.10	$183.70	$183.70