Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.75 / $12.75 / $12.75	Facility	26	$12.75	$12.75	$12.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $43.10 / $78.70	Professional		$42.64	$43.10	$78.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.02 / $12.75 / $50.73	Professional	26	$11.02	$12.75	$50.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.21 / $32.86 / $95.23	Professional	TC	$31.21	$32.86	$95.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.45 / $109.37 / $136.72	Professional		$89.45	$109.37	$136.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $27.93 / $34.90	Professional	26	$22.84	$27.93	$34.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.92 / $81.45 / $101.81	Professional	TC	$65.92	$81.45	$101.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.87 / $83.12 / $306.22	Professional		$49.87	$83.12	$306.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.10 / $24.96 / $95.76	Professional	26	$16.10	$24.96	$95.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.77 / $58.70 / $250.00	Professional	TC	$33.77	$58.70	$250.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $40.47 / $40.47 / $40.47	Facility	26	$40.47	$40.47	$40.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $97.13 / $117.70	Professional		$77.00	$97.13	$117.70
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $68.43 / $90.57	Professional		$50.39	$68.43	$90.57
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.00 / $20.99 / $23.94	Professional	26	$16.00	$20.99	$23.94
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $49.68 / $66.63	Professional	TC	$34.02	$49.68	$66.63
United Facility/Professional Professional Modifier Low / Median / High Price $51.26 / $68.34 / $85.29	Professional		$51.26	$68.34	$85.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.78 / $20.94 / $26.84	Professional	26	$14.78	$20.94	$26.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.63 / $47.41 / $60.33	Professional	TC	$36.63	$47.41	$60.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.90 / $94.00 / $94.00	Professional		$79.90	$94.00	$94.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $21.10 / $24.90 / $24.90	Professional	26	$21.10	$24.90	$24.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $58.80 / $69.20 / $69.20	Professional	TC	$58.80	$69.20	$69.20