Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $14.13	Facility	26	$14.13	$14.13	$14.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $45.71 / $109.65	Professional		$38.90	$45.71	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $44.67	Professional	26	$12.02	$14.13	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $32.36 / $74.13	Professional	TC	$26.92	$32.36	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $128.82	Professional		$83.18	$104.71	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $31.62 / $39.81	Professional	26	$25.12	$31.62	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $72.44 / $91.20	Professional	TC	$57.54	$72.44	$91.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $56.23 / $107.15	Professional		$41.69	$56.23	$107.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $21.88 / $100.00	Professional	26	$13.49	$21.88	$100.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $251.19	Professional	TC	$23.99	$38.02	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $91.20 / $93.33	Professional		$85.11	$91.20	$93.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $28.84 / $34.67	Professional	26	$27.54	$28.84	$34.67
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $58.88 / $64.57	Professional	TC	$57.54	$58.88	$64.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	26	$30.90	$30.90	$30.90
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	TC	$57.54	$57.54	$57.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $63.10 / $85.11	Professional		$50.12	$63.10	$85.11
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.39 / $26.30	Professional	26	$16.60	$22.39	$26.30
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $41.69 / $58.88	Professional	TC	$32.36	$41.69	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $64.57 / $93.33	Professional		$44.67	$64.57	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $23.44 / $29.51	Professional	26	$14.45	$23.44	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $60.26	Professional	TC	$28.84	$40.74	$60.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $87.10	Professional		$74.13	$87.10	$87.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $27.54 / $27.54	Professional	26	$23.44	$27.54	$27.54
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $60.26 / $60.26	Professional	TC	$51.29	$60.26	$60.26