Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $10.96 / $10.96	Facility	26	$10.96	$10.96	$10.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $95.50	Professional		$46.77	$54.95	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.02 / $29.51	Professional	26	$10.96	$12.02	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $74.13	Professional	TC	$37.15	$43.65	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $158.49	Professional		$102.33	$125.89	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.30 / $33.11	Professional	26	$20.89	$26.30	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $100.00 / $125.89	Professional	TC	$81.28	$100.00	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $72.44 / $138.04	Professional		$48.98	$72.44	$138.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.05 / $141.25	Professional	26	$12.02	$19.05	$141.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $57.54 / $275.42	Professional	TC	$35.48	$57.54	$275.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $109.65 / $112.20	Professional		$102.33	$109.65	$112.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $23.99 / $28.84	Professional	26	$22.91	$23.99	$28.84
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $81.28 / $89.13	Professional	TC	$79.43	$81.28	$89.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Professional	26	$25.70	$25.70	$25.70
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	TC	$79.43	$79.43	$79.43
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $102.33	Professional		$56.23	$77.62	$102.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.50 / $21.88	Professional	26	$14.13	$19.50	$21.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $60.26 / $81.28	Professional	TC	$42.66	$60.26	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $83.18 / $117.49	Professional		$53.70	$83.18	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $20.42 / $27.54	Professional	26	$12.02	$20.42	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $60.26 / $89.13	Professional	TC	$38.90	$60.26	$89.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $107.15 / $107.15	Professional		$91.20	$107.15	$107.15
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $22.91 / $22.91	Professional	26	$19.50	$22.91	$22.91
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $83.18 / $83.18	Professional	TC	$70.79	$83.18	$83.18