Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.64 / $10.64 / $10.64	Facility	26	$10.64	$10.64	$10.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.19 / $37.67 / $69.15	Professional		$37.19	$37.67	$69.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $9.98 / $16.09	Professional	26	$9.19	$9.98	$16.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $27.98 / $53.05	Professional	TC	$27.69	$27.98	$53.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $95.41 / $119.26	Professional		$78.03	$95.41	$119.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.03 / $23.27 / $29.09	Professional	26	$19.03	$23.27	$29.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.27 / $72.14 / $90.18	Professional	TC	$57.27	$72.14	$90.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $71.93 / $267.27	Professional		$42.97	$71.93	$267.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $20.95 / $85.85	Professional	26	$13.52	$20.95	$85.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.45 / $51.53 / $244.00	Professional	TC	$29.45	$51.53	$244.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $34.69 / $34.69 / $34.69	Facility	26	$34.69	$34.69	$34.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $68.52 / $82.74 / $103.29	Professional		$68.52	$82.74	$103.29
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $59.58 / $79.56	Professional		$43.50	$59.58	$79.56
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.45 / $17.59 / $20.05	Professional	26	$13.45	$17.59	$20.05
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.02 / $44.37 / $59.51	Professional	TC	$30.02	$44.37	$59.51
United Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $71.62 / $73.93	Professional		$44.41	$71.62	$73.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $20.38 / $28.37	Professional	26	$12.39	$20.38	$28.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.98 / $41.63 / $52.98	Professional	TC	$31.98	$41.63	$52.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $82.60 / $82.60	Professional		$70.20	$82.60	$82.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $20.80 / $20.80	Professional	26	$17.70	$20.80	$20.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $52.50 / $61.80 / $61.80	Professional	TC	$52.50	$61.80	$61.80