Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.64 / $10.64 / $10.64	Facility	26	$10.64	$10.64	$10.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $38.92 / $63.34	Professional		$33.86	$38.92	$63.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $11.23 / $16.09	Professional	26	$9.19	$11.23	$16.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $27.69 / $47.26	Professional	TC	$24.65	$27.69	$47.26
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 $19.03 / $23.27 / $29.09	Professional	26	$19.03	$23.27	$29.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.75 / $64.38 / $80.48	Professional	TC	$51.75	$64.38	$80.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $67.93 / $262.00	Professional		$42.97	$67.93	$262.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $20.94 / $107.32	Professional	26	$13.58	$20.94	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.89 / $46.99 / $249.00	Professional	TC	$29.89	$46.99	$249.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $40.28 / $40.28 / $40.28	Facility	26	$40.28	$40.28	$40.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $71.16 / $80.58 / $93.68	Professional		$71.16	$80.58	$93.68
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $44.62 / $61.35 / $73.09	Professional		$44.62	$61.35	$73.09
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.16 / $17.59 / $20.89	Professional	26	$14.16	$17.59	$20.89
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $40.19 / $53.05	Professional	TC	$30.14	$40.19	$53.05
United Facility/Professional Professional Modifier Low / Median / High Price $44.06 / $67.93 / $83.12	Professional		$44.06	$67.93	$83.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $19.05 / $25.40	Professional	26	$11.04	$19.05	$25.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.20 / $45.72 / $57.34	Professional	TC	$29.20	$45.72	$57.34
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 $17.70 / $20.80 / $20.80	Professional	26	$17.70	$20.80	$20.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $46.80 / $55.10 / $55.10	Professional	TC	$46.80	$55.10	$55.10