Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.61 / $14.61 / $14.61	Facility	26	$14.61	$14.61	$14.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $67.65 / $104.80	Professional		$56.39	$67.65	$104.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $18.38 / $63.90	Professional	26	$12.65	$18.38	$63.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.74 / $50.93 / $82.60	Professional	TC	$43.74	$50.93	$82.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.26 / $145.83 / $182.29	Professional		$119.26	$145.83	$182.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $32.58 / $40.72	Professional	26	$26.64	$32.58	$40.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.40 / $113.25 / $141.57	Professional	TC	$90.40	$113.25	$141.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.26 / $110.65 / $399.42	Professional		$67.26	$110.65	$399.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.35 / $28.29 / $137.04	Professional	26	$18.35	$28.29	$137.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $45.38 / $79.42 / $356.00	Professional	TC	$45.38	$79.42	$356.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $58.69 / $58.69 / $58.69	Facility	26	$58.69	$58.69	$58.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.35 / $132.35 / $156.13	Professional		$107.35	$132.35	$156.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $68.04 / $92.61 / $120.32	Professional		$68.04	$92.61	$120.32
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.64 / $24.40 / $30.75	Professional	26	$19.64	$24.40	$30.75
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $48.51 / $68.97 / $92.51	Professional	TC	$48.51	$68.97	$92.51
United Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $110.65 / $112.10	Professional		$71.77	$110.65	$112.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $27.52 / $36.46	Professional	26	$17.18	$27.52	$36.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.65 / $80.14 / $82.36	Professional	TC	$51.65	$80.14	$82.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $106.20 / $124.90 / $124.90	Professional		$106.20	$124.90	$124.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $24.60 / $28.90 / $28.90	Professional	26	$24.60	$28.90	$28.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $81.59 / $96.10 / $96.10	Professional	TC	$81.59	$96.10	$96.10