Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.04 / $12.04 / $12.04	Facility	26	$12.04	$12.04	$12.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $45.07 / $75.30	Professional		$40.22	$45.07	$75.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $10.41 / $18.19	Professional	26	$9.98	$10.41	$18.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.80 / $35.09 / $57.10	Professional	TC	$29.80	$35.09	$57.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.01 / $103.94 / $129.93	Professional		$85.01	$103.94	$129.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.57 / $26.37 / $32.97	Professional	26	$21.57	$26.37	$32.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.70 / $77.56 / $96.96	Professional	TC	$62.70	$77.56	$96.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.85 / $78.08 / $286.68	Professional		$46.85	$78.08	$286.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $22.32 / $107.32	Professional	26	$13.09	$22.32	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.76 / $56.26 / $267.00	Professional	TC	$33.76	$56.26	$267.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $34.50 / $34.50 / $34.50	Facility	26	$34.50	$34.50	$34.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $88.22 / $110.49	Professional		$74.56	$88.22	$110.49
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $47.38 / $64.63 / $86.68	Professional		$47.38	$64.63	$86.68
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $18.29 / $22.64	Professional	26	$13.36	$18.29	$22.64
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $47.75 / $64.04	Professional	TC	$34.02	$47.75	$64.04
United Facility/Professional Professional Modifier Low / Median / High Price $50.90 / $77.78 / $79.94	Professional		$50.90	$77.78	$79.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.98 / $19.32 / $22.94	Professional	26	$13.98	$19.32	$22.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $56.26 / $73.56	Professional	TC	$36.97	$56.26	$73.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $76.50 / $90.00 / $90.00	Professional		$76.50	$90.00	$90.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $20.00 / $23.50 / $23.50	Professional	26	$20.00	$23.50	$23.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $56.50 / $66.50 / $66.50	Professional	TC	$56.50	$66.50	$66.50