Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $200.50 / $200.50 / $200.50	Facility	26	$200.50	$200.50	$200.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.05 / $316.58 / $791.21	Professional		$288.05	$316.58	$791.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $183.89 / $347.57	Professional	26	$171.18	$183.89	$347.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $108.00 / $116.85 / $174.46	Professional	TC	$108.00	$116.85	$174.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $513.80 / $593.22 / $741.52	Professional		$513.80	$593.22	$741.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $327.63 / $378.26 / $472.83	Professional	26	$327.63	$378.26	$472.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.18 / $218.06 / $268.69	Professional	TC	$186.18	$218.06	$268.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $298.77 / $621.70 / $1,850.58	Professional		$298.77	$621.70	$1,850.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $207.31 / $351.82 / $1,166.03	Professional	26	$207.31	$351.82	$1,166.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $110.32 / $220.64 / $684.55	Professional	TC	$110.32	$220.64	$684.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $444.44 / $586.69 / $723.12	Professional		$444.44	$586.69	$723.12
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $338.18 / $467.42 / $549.87	Professional		$338.18	$467.42	$549.87
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $218.03 / $301.35 / $354.50	Professional	26	$218.03	$301.35	$354.50
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $121.42 / $166.07 / $195.36	Professional	TC	$121.42	$166.07	$195.36
United Facility/Professional Professional Modifier Low / Median / High Price $298.77 / $547.91 / $644.60	Professional		$298.77	$547.91	$644.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $188.46 / $333.99 / $471.15	Professional	26	$188.46	$333.99	$471.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.32 / $205.97 / $242.32	Professional	TC	$110.32	$205.97	$242.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $567.20 / $693.90 / $693.90	Professional		$567.20	$693.90	$693.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $365.70 / $447.40 / $447.40	Professional	26	$365.70	$447.40	$447.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $201.50 / $246.60 / $246.60	Professional	TC	$201.50	$246.60	$246.60