Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.45 / $13.45 / $13.45	Facility	26	$13.45	$13.45	$13.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.06 / $31.06 / $31.06	Facility	TC	$31.06	$31.06	$31.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $38.24 / $70.51	Professional		$38.10	$38.24	$70.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.63 / $13.17 / $20.35	Professional	26	$11.63	$13.17	$20.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $26.47 / $50.15	Professional	TC	$25.05	$26.47	$50.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $97.74 / $122.17	Professional		$79.93	$97.74	$122.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.11 / $29.48 / $36.85	Professional	26	$24.11	$29.48	$36.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.75 / $68.26 / $85.33	Professional	TC	$55.75	$68.26	$85.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $76.61 / $271.47	Professional		$46.18	$76.61	$271.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.62 / $25.62 / $81.06	Professional	26	$16.62	$25.62	$81.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.88 / $49.80 / $190.40	Professional	TC	$29.88	$49.80	$190.40
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $47.34 / $47.34 / $47.34	Facility	26	$47.34	$47.34	$47.34
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $82.74 / $82.74 / $82.74	Facility	TC	$82.74	$82.74	$82.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.56 / $88.60 / $105.69	Professional		$84.56	$88.60	$105.69
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $51.92 / $71.48 / $81.51	Professional		$51.92	$71.48	$81.51
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.42 / $22.13 / $25.23	Professional	26	$14.42	$22.13	$25.23
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.82 / $49.36 / $56.28	Professional	TC	$29.82	$49.36	$56.28
United Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $61.57 / $89.67	Professional		$46.18	$61.57	$89.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.58 / $24.93 / $30.51	Professional	26	$15.58	$24.93	$30.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.35 / $40.04 / $50.99	Professional	TC	$31.35	$40.04	$50.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $71.90 / $84.60 / $84.60	Professional		$71.90	$84.60	$84.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $22.30 / $26.20 / $26.20	Professional	26	$22.30	$26.20	$26.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $49.70 / $58.40 / $58.40	Professional	TC	$49.70	$58.40	$58.40