Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $199.53 / $199.53	Facility	26	$190.55	$199.53	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $912.01	Professional		$269.15	$389.05	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $239.88 / $489.78	Professional	26	$173.78	$239.88	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $114.82 / $223.87	Professional	TC	$97.72	$114.82	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $616.60 / $758.58	Professional		$575.44	$616.60	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $354.81 / $389.05 / $489.78	Professional	26	$354.81	$389.05	$489.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $223.87 / $275.42	Professional	TC	$213.80	$223.87	$275.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $524.81 / $1,862.09	Professional		$269.15	$524.81	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $331.13 / $1,174.90	Professional	26	$190.55	$331.13	$1,174.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $186.21 / $691.83	Professional	TC	$109.65	$186.21	$691.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $588.84 / $707.95	Professional		$575.44	$588.84	$707.95
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $354.81 / $371.54 / $457.09	Professional	26	$354.81	$371.54	$457.09
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $229.09 / $245.47	Professional	TC	$213.80	$229.09	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $676.08	Professional		$575.44	$575.44	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $354.81 / $354.81 / $426.58	Professional	26	$354.81	$354.81	$426.58
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $245.47	Professional	TC	$229.09	$229.09	$245.47
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $616.60	Professional		$331.13	$478.63	$616.60
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $213.80 / $309.03 / $389.05	Professional	26	$213.80	$309.03	$389.05
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $173.78 / $223.87	Professional	TC	$117.49	$173.78	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $512.86 / $645.65	Professional		$331.13	$512.86	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $323.59 / $407.38	Professional	26	$208.93	$323.59	$407.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $190.55 / $239.88	Professional	TC	$120.23	$190.55	$239.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $691.83 / $691.83	Professional		$562.34	$691.83	$691.83
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $363.08 / $446.68 / $446.68	Professional	26	$363.08	$446.68	$446.68
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $245.47 / $245.47	Professional	TC	$199.53	$245.47	$245.47