Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.66 / $15.66 / $15.66	Facility	26	$15.66	$15.66	$15.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.30 / $53.00 / $87.85	Professional		$47.30	$53.00	$87.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.39 / $15.86 / $55.18	Professional	26	$14.39	$15.86	$55.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.74 / $39.59 / $256.32	Professional	TC	$33.74	$39.59	$256.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.23 / $122.56 / $153.19	Professional		$100.23	$122.56	$153.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.55 / $34.90 / $43.63	Professional	26	$28.55	$34.90	$43.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.59 / $87.65 / $109.57	Professional	TC	$70.59	$87.65	$109.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.40 / $95.29 / $338.57	Professional		$57.40	$95.29	$338.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.64 / $30.28 / $117.24	Professional	26	$19.64	$30.28	$117.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.07 / $63.46 / $291.00	Professional	TC	$38.07	$63.46	$291.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $51.23 / $51.23 / $51.23	Facility	26	$51.23	$51.23	$51.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $108.80 / $134.76	Professional		$91.00	$108.80	$134.76
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.57 / $78.09 / $101.56	Professional		$58.57	$78.09	$101.56
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.66 / $26.10 / $29.76	Professional	26	$19.66	$26.10	$29.76
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $38.29 / $53.54 / $71.81	Professional	TC	$38.29	$53.54	$71.81
United Facility/Professional Professional Modifier Low / Median / High Price $57.40 / $77.06 / $96.32	Professional		$57.40	$77.06	$96.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $27.93 / $34.51	Professional	26	$18.37	$27.93	$34.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.89 / $63.25 / $65.01	Professional	TC	$39.89	$63.25	$65.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $89.60 / $105.50 / $105.50	Professional		$89.60	$105.50	$105.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.90 / $30.90	Professional	26	$26.30	$30.90	$30.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $63.40 / $74.59 / $74.59	Professional	TC	$63.40	$74.59	$74.59