Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $364.33 / $364.33 / $364.33	Professional		$364.33	$364.33	$364.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $191.17 / $191.17 / $191.17	Professional	26	$191.17	$191.17	$191.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.16 / $173.16 / $173.16	Professional	TC	$173.16	$173.16	$173.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $415.50 / $519.38 / $584.46	Professional		$415.50	$519.38	$584.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $193.88 / $242.34 / $289.68	Professional	26	$193.88	$242.34	$289.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.63 / $277.02 / $294.79	Professional	TC	$221.63	$277.02	$294.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $623.88 / $675.76 / $2,346.29	Facility		$623.88	$675.76	$2,346.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $207.51 / $599.07 / $5,718.36	Professional		$207.51	$599.07	$5,718.36
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $110.48 / $332.16 / $1,098.38	Professional	26	$110.48	$332.16	$1,098.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $97.03 / $547.27 / $2,229.25	Professional	TC	$97.03	$547.27	$2,229.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $589.29 / $854.75 / $971.00	Facility		$589.29	$854.75	$971.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $531.78 / $589.29 / $830.10	Professional		$531.78	$589.29	$830.10
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $528.60 / $679.54 / $1,048.42	Professional		$528.60	$679.54	$1,048.42
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $218.39 / $292.77 / $333.80	Professional	26	$218.39	$292.77	$333.80
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $279.73 / $365.64 / $753.10	Professional	TC	$279.73	$365.64	$753.10
United Facility/Professional Professional Modifier Low / Median / High Price $207.51 / $217.50 / $977.14	Professional		$207.51	$217.50	$977.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.66 / $110.48 / $376.98	Professional	26	$102.66	$110.48	$376.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.03 / $114.84 / $608.08	Professional	TC	$97.03	$114.84	$608.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $621.79 / $784.80 / $843.90	Professional		$621.79	$784.80	$843.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $292.80 / $369.50 / $397.30	Professional	26	$292.80	$369.50	$397.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $329.10 / $415.30 / $446.60	Professional	TC	$329.10	$415.30	$446.60