Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.87 / $126.87 / $126.87	Facility	26	$126.87	$126.87	$126.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $348.98 / $453.71 / $755.37	Professional	TC	$348.98	$453.71	$755.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $756.14 / $931.70 / $1,164.61	Professional	TC	$756.14	$931.70	$1,164.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $391.87 / $777.78 / $2,779.03	Professional	TC	$391.87	$777.78	$2,779.03
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $138.46 / $191.37 / $225.12	Professional	26	$138.46	$191.37	$225.12
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $467.70 / $629.88 / $844.85	Professional	TC	$467.70	$629.88	$844.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $427.78 / $777.78 / $974.84	Professional	TC	$427.78	$777.78	$974.84
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $871.40 / $1,066.20 / $1,066.20	Professional	TC	$871.40	$1,066.20	$1,066.20