Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.13 / $113.13 / $113.13	Facility	26	$113.13	$113.13	$113.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.99 / $247.02 / $690.64	Professional		$175.99	$247.02	$690.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $104.25 / $189.23	Professional	26	$96.29	$104.25	$189.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.02 / $79.70 / $121.40	Professional	TC	$76.02	$79.70	$121.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.94 / $367.24 / $454.51	Professional		$314.94	$367.24	$454.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $185.58 / $214.26 / $267.82	Professional	26	$185.58	$214.26	$267.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.36 / $151.51 / $186.69	Professional	TC	$129.36	$151.51	$186.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.23 / $374.70 / $1,142.65	Professional		$198.23	$374.70	$1,142.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $118.81 / $200.31 / $663.65	Professional	26	$118.81	$200.31	$663.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $90.22 / $176.86 / $479.00	Professional	TC	$90.22	$176.86	$479.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $293.04 / $374.70 / $475.84	Professional		$293.04	$374.70	$475.84
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $210.65 / $285.39 / $335.74	Professional		$210.65	$285.39	$335.74
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $122.94 / $169.92 / $199.89	Professional	26	$122.94	$169.92	$199.89
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $86.99 / $115.48 / $146.88	Professional	TC	$86.99	$115.48	$146.88
United Facility/Professional Professional Modifier Low / Median / High Price $218.05 / $349.52 / $484.80	Professional		$218.05	$349.52	$484.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.01 / $194.75 / $229.11	Professional	26	$108.01	$194.75	$229.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.22 / $151.60 / $189.46	Professional	TC	$90.22	$151.60	$189.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $346.30 / $423.70 / $423.70	Professional		$346.30	$423.70	$423.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $206.20 / $252.30 / $252.30	Professional	26	$206.20	$252.30	$252.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $140.10 / $171.40 / $171.40	Professional	TC	$140.10	$171.40	$171.40