Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.20 / $15.20 / $15.20	Facility	26	$15.20	$15.20	$15.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.54 / $33.54 / $33.54	Facility	TC	$33.54	$33.54	$33.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.96 / $41.13 / $76.59	Professional		$40.96	$41.13	$76.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $15.17 / $22.96	Professional	26	$12.84	$15.17	$22.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.78 / $28.29 / $53.64	Professional	TC	$25.78	$28.29	$53.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.91 / $106.27 / $132.84	Professional		$86.91	$106.27	$132.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.28 / $33.36 / $41.69	Professional	26	$27.28	$33.36	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.89 / $72.92 / $91.14	Professional	TC	$57.89	$72.92	$91.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.28 / $83.29 / $297.38	Professional		$50.28	$83.29	$297.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $30.29 / $93.99	Professional	26	$19.55	$30.29	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.74 / $51.24 / $203.39	Professional	TC	$30.74	$51.24	$203.39
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $54.41 / $54.41 / $54.41	Facility	26	$54.41	$54.41	$54.41
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $85.12 / $85.12 / $85.12	Facility	TC	$85.12	$85.12	$85.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.85 / $95.95 / $116.50	Professional		$91.85	$95.95	$116.50
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $55.69 / $77.73 / $88.63	Professional		$55.69	$77.73	$88.63
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $24.97 / $28.46	Professional	26	$16.57	$24.97	$28.46
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.19 / $52.77 / $60.22	Professional	TC	$32.19	$52.77	$60.22
United Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $83.29 / $83.82	Professional		$50.29	$83.29	$83.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $25.41 / $32.58	Professional	26	$17.17	$25.41	$32.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $41.63 / $53.00	Professional	TC	$33.36	$41.63	$53.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.20 / $92.00 / $92.00	Professional		$78.20	$92.00	$92.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $25.10 / $29.60 / $29.60	Professional	26	$25.10	$29.60	$29.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $53.10 / $62.50 / $62.50	Professional	TC	$53.10	$62.50	$62.50