Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.15 / $14.15 / $14.15	Facility	26	$14.15	$14.15	$14.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $40.92 / $73.26	Professional		$39.61	$40.92	$73.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.18 / $12.23 / $21.37	Professional	26	$12.18	$12.23	$21.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $28.75 / $51.90	Professional	TC	$27.38	$28.75	$51.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.10 / $101.62 / $127.02	Professional		$83.10	$101.62	$127.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.38 / $31.03 / $38.79	Professional	26	$25.38	$31.03	$38.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.32 / $70.59 / $88.24	Professional	TC	$57.32	$70.59	$88.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $77.78 / $282.23	Professional		$45.13	$77.78	$282.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.54 / $27.56 / $100.72	Professional	26	$16.54	$27.56	$100.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $50.04 / $254.00	Professional	TC	$28.59	$50.04	$254.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $42.26 / $42.26 / $42.26	Facility	26	$42.26	$42.26	$42.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $91.88 / $110.49	Professional		$72.20	$91.88	$110.49
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $45.65 / $63.18 / $84.74	Professional		$45.65	$63.18	$84.74
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $22.63 / $26.52	Professional	26	$16.73	$22.63	$26.52
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.84 / $43.41 / $58.22	Professional	TC	$30.84	$43.41	$58.22
United Facility/Professional Professional Modifier Low / Median / High Price $48.23 / $64.30 / $79.94	Professional		$48.23	$64.30	$79.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.38 / $26.88 / $29.63	Professional	26	$16.38	$26.88	$29.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $47.66 / $54.78	Professional	TC	$32.40	$47.66	$54.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.80 / $88.00 / $88.00	Professional		$74.80	$88.00	$88.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $27.50 / $27.50	Professional	26	$23.40	$27.50	$27.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $51.40 / $60.50 / $60.50	Professional	TC	$51.40	$60.50	$60.50