Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $13.80 / $13.80	Facility	26	$13.80	$13.80	$13.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.25 / $48.84 / $80.29	Professional		$43.25	$48.84	$80.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $13.80 / $20.86	Professional	26	$11.93	$13.80	$20.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.32 / $34.72 / $59.42	Professional	TC	$31.32	$34.72	$59.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.35 / $111.70 / $139.63	Professional		$91.35	$111.70	$139.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.74 / $30.25 / $37.82	Professional	26	$24.74	$30.25	$37.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.12 / $81.45 / $101.81	Professional	TC	$65.12	$81.45	$101.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $84.54 / $438.00	Professional		$50.72	$84.54	$438.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.97 / $26.29 / $97.41	Professional	26	$16.97	$26.29	$97.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.75 / $58.70 / $423.00	Professional	TC	$33.75	$58.70	$423.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $44.32 / $44.32 / $44.32	Facility	26	$44.32	$44.32	$44.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $98.06 / $120.10	Professional		$79.00	$98.06	$120.10
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $69.61 / $92.51	Professional		$51.25	$69.61	$92.51
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.16 / $22.70 / $25.88	Professional	26	$17.16	$22.70	$25.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $35.24 / $49.68 / $66.63	Professional	TC	$35.24	$49.68	$66.63
United Facility/Professional Professional Modifier Low / Median / High Price $52.13 / $69.50 / $86.62	Professional		$52.13	$69.50	$86.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.99 / $26.29 / $28.28	Professional	26	$15.99	$26.29	$28.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.64 / $47.40 / $60.33	Professional	TC	$36.64	$47.40	$60.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $96.10 / $96.10	Professional		$81.59	$96.10	$96.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $22.80 / $26.90 / $26.90	Professional	26	$22.80	$26.90	$26.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $58.80 / $69.20 / $69.20	Professional	TC	$58.80	$69.20	$69.20