Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.53 / $8.53 / $8.53	Facility	26	$8.53	$8.53	$8.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.35 / $33.86 / $63.71	Professional		$33.35	$33.86	$63.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.74 / $30.60	Professional	26	$7.08	$8.74	$30.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $31.77 / $82.77	Professional	TC	$25.57	$31.77	$82.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.68 / $87.65 / $109.57	Professional		$71.68	$87.65	$109.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.23 / $18.62 / $23.27	Professional	26	$15.23	$18.62	$23.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.75 / $69.04 / $86.30	Professional	TC	$55.75	$69.04	$86.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.10 / $65.45 / $245.68	Professional		$39.10	$65.45	$245.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $16.27 / $61.09	Professional	26	$10.24	$16.27	$61.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.58 / $49.63 / $192.57	Professional	TC	$28.58	$49.63	$192.57
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.56 / $27.56 / $27.56	Facility	26	$27.56	$27.56	$27.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $76.12 / $96.08	Professional		$52.00	$76.12	$96.08
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $54.50 / $73.09	Professional		$39.04	$54.50	$73.09
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.73 / $14.19 / $16.17	Professional	26	$10.73	$14.19	$16.17
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.86 / $42.44 / $56.93	Professional	TC	$28.86	$42.44	$56.93
United Facility/Professional Professional Modifier Low / Median / High Price $40.27 / $65.16 / $68.19	Professional		$40.27	$65.16	$68.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $16.27 / $22.77	Professional	26	$9.59	$16.27	$22.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.04 / $40.04 / $51.00	Professional	TC	$31.04	$40.04	$51.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $64.50 / $75.90 / $75.90	Professional		$64.50	$75.90	$75.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $16.80 / $16.80	Professional	26	$14.30	$16.80	$16.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $50.20 / $59.10 / $59.10	Professional	TC	$50.20	$59.10	$59.10