Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.45 / $13.45 / $13.45	Facility	26	$13.45	$13.45	$13.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $53.11 / $91.36	Professional		$48.40	$53.11	$91.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $20.35 / $50.73	Professional	26	$12.24	$20.35	$50.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.60 / $71.01 / $338.40	Professional	TC	$38.60	$71.01	$338.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $126.44 / $158.05	Professional		$103.40	$126.44	$158.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.11 / $29.48 / $36.85	Professional	26	$24.11	$29.48	$36.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.08 / $96.96 / $121.20	Professional	TC	$75.08	$96.96	$121.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $91.42 / $343.08	Professional		$54.35	$91.42	$343.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.62 / $25.62 / $113.92	Professional	26	$16.62	$25.62	$113.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.47 / $62.10 / $259.85	Professional	TC	$35.47	$62.10	$259.85
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $51.19 / $51.19 / $51.19	Facility	26	$51.19	$51.19	$51.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $86.85 / $111.85 / $135.46	Professional		$86.85	$111.85	$135.46
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $55.13 / $78.13 / $104.80	Professional		$55.13	$78.13	$104.80
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.42 / $22.13 / $26.11	Professional	26	$17.42	$22.13	$26.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $38.29 / $59.32 / $79.56	Professional	TC	$38.29	$59.32	$79.56
United Facility/Professional Professional Modifier Low / Median / High Price $57.34 / $90.58 / $98.41	Professional		$57.34	$90.58	$98.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.18 / $24.93 / $33.01	Professional	26	$15.18	$24.93	$33.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.27 / $53.70 / $68.34	Professional	TC	$40.27	$53.70	$68.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $92.50 / $108.80 / $108.80	Professional		$92.50	$108.80	$108.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $22.30 / $26.20 / $26.20	Professional	26	$22.30	$26.20	$26.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $70.20 / $82.60 / $82.60	Professional	TC	$70.20	$82.60	$82.60