Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.69 / $11.69 / $11.69	Facility	26	$11.69	$11.69	$11.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.79 / $53.72 / $89.84	Professional		$47.79	$53.72	$89.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $11.69 / $17.68	Professional	26	$10.11	$11.69	$17.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.56 / $38.13 / $72.16	Professional	TC	$37.56	$38.13	$72.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.50 / $124.11 / $155.13	Professional		$101.50	$124.11	$155.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.93 / $25.60 / $32.00	Professional	26	$20.93	$25.60	$32.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.19 / $98.51 / $123.14	Professional	TC	$80.19	$98.51	$123.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.48 / $95.96 / $345.31	Professional		$57.48	$95.96	$345.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.88 / $22.94 / $142.00	Professional	26	$14.88	$22.94	$142.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $42.80 / $71.34 / $272.83	Professional	TC	$42.80	$71.34	$272.83
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $40.31 / $40.31 / $40.31	Facility	26	$40.31	$40.31	$40.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $109.47 / $132.11	Professional		$79.00	$109.47	$132.11
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $56.64 / $77.87 / $102.86	Professional		$56.64	$77.87	$102.86
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.08 / $19.29 / $21.99	Professional	26	$15.08	$19.29	$21.99
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $42.36 / $60.29 / $80.86	Professional	TC	$42.36	$60.29	$80.86
United Facility/Professional Professional Modifier Low / Median / High Price $62.24 / $95.96 / $149.69	Professional		$62.24	$95.96	$149.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.59 / $22.94 / $25.40	Professional	26	$13.59	$22.94	$25.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.52 / $57.38 / $73.02	Professional	TC	$44.52	$57.38	$73.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $90.80 / $106.80 / $106.80	Professional		$90.80	$106.80	$106.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $22.80 / $22.80	Professional	26	$19.39	$22.80	$22.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $71.40 / $84.00 / $84.00	Professional	TC	$71.40	$84.00	$84.00