Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.50 / $48.50 / $48.50	Facility	26	$48.50	$48.50	$48.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.89 / $383.81 / $638.79	Professional		$292.89	$383.81	$638.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $167.55 / $205.30 / $231.85	Professional	52	$167.55	$205.30	$231.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.77 / $339.06 / $569.08	Professional	TC	$252.77	$339.06	$569.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $644.00 / $793.51 / $991.89	Professional		$644.00	$793.51	$991.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $569.79 / $702.09 / $877.61	Professional	TC	$569.79	$702.09	$877.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.02 / $653.03 / $2,332.00	Professional		$346.02	$653.03	$2,332.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $299.73 / $599.46 / $2,048.28	Professional	TC	$299.73	$599.46	$2,048.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $498.15 / $653.03 / $776.71	Professional		$498.15	$653.03	$776.71
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $412.75 / $558.15 / $722.59	Professional		$412.75	$558.15	$722.59
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $52.92 / $73.14 / $86.04	Professional	26	$52.92	$73.14	$86.04
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $357.41 / $483.31 / $636.54	Professional	TC	$357.41	$483.31	$636.54
United Facility/Professional Professional Modifier Low / Median / High Price $346.02 / $637.70 / $782.43	Professional		$346.02	$637.70	$782.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $299.73 / $549.39 / $660.42	Professional	TC	$299.73	$549.39	$660.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $745.30 / $911.90 / $911.90	Professional		$745.30	$911.90	$911.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $656.60 / $803.30 / $803.30	Professional	TC	$656.60	$803.30	$803.30