Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $112.20 / $112.20	Facility	26	$109.65	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $407.38 / $630.96	Professional		$173.78	$407.38	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $112.20 / $257.04	Professional	26	$97.72	$112.20	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $81.28 / $162.18	Professional	TC	$67.61	$81.28	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $467.74	Professional		$371.54	$371.54	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $218.78 / $275.42	Professional	26	$199.53	$218.78	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $154.88 / $190.55	Professional	TC	$151.36	$154.88	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $331.13 / $1,148.15	Professional		$165.96	$331.13	$1,148.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $660.69	Professional	26	$107.15	$181.97	$660.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $138.04 / $478.63	Professional	TC	$91.20	$138.04	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $371.54 / $426.58	Professional		$354.81	$371.54	$426.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $213.80 / $257.04	Professional	26	$199.53	$213.80	$257.04
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $162.18 / $169.82	Professional	TC	$154.88	$162.18	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $446.68	Professional		$354.81	$354.81	$446.68
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $199.53 / $245.47	Professional	26	$199.53	$199.53	$245.47
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $154.88 / $204.17	Professional	TC	$154.88	$154.88	$204.17
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $295.12 / $380.19	Professional		$204.17	$295.12	$380.19
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $173.78 / $223.87	Professional	26	$120.23	$173.78	$223.87
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $128.82 / $154.88	Professional	TC	$83.18	$128.82	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $331.13 / $416.87	Professional		$213.80	$331.13	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $181.97 / $229.09	Professional	26	$117.49	$181.97	$229.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $138.04 / $190.55	Professional	TC	$93.33	$138.04	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $426.58 / $426.58	Professional		$346.74	$426.58	$426.58
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $251.19 / $251.19	Professional	26	$204.17	$251.19	$251.19
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $169.82 / $169.82	Professional	TC	$141.25	$169.82	$169.82