Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $12.88	Facility	26	$12.88	$12.88	$12.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $43.65 / $117.49	Professional		$13.49	$43.65	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $20.42 / $44.67	Professional	26	$12.30	$20.42	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $100.00	Professional	TC	$26.92	$44.67	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $125.89	Professional		$79.43	$100.00	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $29.51 / $36.31	Professional	26	$23.44	$29.51	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $70.79 / $89.13	Professional	TC	$56.23	$70.79	$89.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $102.33	Professional		$36.31	$54.95	$102.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $24.55 / $45.71	Professional	26	$13.49	$24.55	$45.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $36.31 / $229.09	Professional	TC	$23.44	$36.31	$229.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $89.13	Professional		$83.18	$87.10	$89.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.92 / $31.62	Professional	26	$25.70	$26.92	$31.62
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $57.54 / $63.10	Professional	TC	$56.23	$57.54	$63.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $27.54 / $27.54	Professional	26	$27.54	$27.54	$27.54
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	TC	$56.23	$56.23	$56.23
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $81.28	Professional		$46.77	$60.26	$81.28
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.38 / $24.55	Professional	26	$15.85	$21.38	$24.55
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $40.74 / $57.54	Professional	TC	$30.20	$40.74	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $61.66 / $91.20	Professional		$41.69	$61.66	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $22.39 / $29.51	Professional	26	$13.49	$22.39	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $39.81 / $56.23	Professional	TC	$27.54	$39.81	$56.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $85.11	Professional		$72.44	$85.11	$85.11
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $25.70 / $25.70	Professional	26	$21.88	$25.70	$25.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $58.88 / $58.88	Professional	TC	$50.12	$58.88	$58.88