Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.12 / $169.12 / $169.12	Facility	26	$169.12	$169.12	$169.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.78 / $274.20 / $932.72	Professional		$248.78	$274.20	$932.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $155.52 / $415.22	Professional	26	$144.25	$155.52	$415.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.96 / $104.53 / $152.46	Professional	TC	$95.96	$104.53	$152.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $438.86 / $506.68 / $633.34	Professional		$438.86	$506.68	$633.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $276.25 / $318.94 / $398.68	Professional	26	$276.25	$318.94	$398.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.61 / $190.45 / $234.67	Professional	TC	$162.61	$190.45	$234.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $260.31 / $507.44 / $1,600.14	Professional		$260.31	$507.44	$1,600.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $159.32 / $318.64 / $982.86	Professional	26	$159.32	$318.64	$982.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $100.99 / $201.98 / $617.27	Professional	TC	$100.99	$201.98	$617.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $386.71 / $507.44 / $658.23	Professional		$386.71	$507.44	$658.23
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $290.77 / $399.23 / $469.65	Professional		$290.77	$399.23	$469.65
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $183.81 / $254.05 / $298.87	Professional	26	$183.81	$254.05	$298.87
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $109.63 / $145.16 / $170.78	Professional	TC	$109.63	$145.16	$170.78
United Facility/Professional Professional Modifier Low / Median / High Price $260.31 / $473.35 / $556.88	Professional		$260.31	$473.35	$556.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $175.25 / $288.00 / $338.82	Professional	26	$175.25	$288.00	$338.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.09 / $169.83 / $218.06	Professional	TC	$111.09	$169.83	$218.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $484.40 / $592.70 / $592.70	Professional		$484.40	$592.70	$592.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $308.30 / $377.20 / $377.20	Professional	26	$308.30	$377.20	$377.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $176.20 / $215.50 / $215.50	Professional	TC	$176.20	$215.50	$215.50