Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.34 / $109.34 / $109.34	Facility	26	$109.34	$109.34	$109.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.18 / $347.32 / $487.30	Professional		$299.18	$347.32	$487.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.31 / $100.82 / $156.32	Professional	26	$94.31	$100.82	$156.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.35 / $253.00 / $330.97	Professional	TC	$198.35	$253.00	$330.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.44 / $613.45 / $766.82	Professional		$501.44	$613.45	$766.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $176.56 / $207.94 / $257.35	Professional	26	$176.56	$207.94	$257.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $330.78 / $407.57 / $509.47	Professional	TC	$330.78	$407.57	$509.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $307.04 / $521.97 / $2,013.87	Professional		$307.04	$521.97	$2,013.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.92 / $209.84 / $716.57	Professional	26	$104.92	$209.84	$716.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $201.75 / $324.45 / $1,590.04	Professional	TC	$201.75	$324.45	$1,590.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $448.19 / $522.58 / $726.60	Professional		$448.19	$522.58	$726.60
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $309.85 / $478.96 / $563.45	Professional		$309.85	$478.96	$563.45
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $114.79 / $163.87 / $192.78	Professional	26	$114.79	$163.87	$192.78
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $185.92 / $315.08 / $370.67	Professional	TC	$185.92	$315.08	$370.67
United Facility/Professional Professional Modifier Low / Median / High Price $307.04 / $461.51 / $644.78	Professional		$307.04	$461.51	$644.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.92 / $187.29 / $220.33	Professional	26	$104.92	$187.29	$220.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.75 / $278.10 / $424.45	Professional	TC	$201.75	$278.10	$424.45
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $581.20 / $711.10 / $711.10	Professional		$581.20	$711.10	$711.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $198.80 / $243.30 / $243.30	Professional	26	$198.80	$243.30	$243.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $382.30 / $467.80 / $467.80	Professional	TC	$382.30	$467.80	$467.80