Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.00 / $10.00	Facility	26	$10.00	$10.00	$10.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $85.11	Professional		$32.36	$40.74	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.96 / $33.88	Professional	26	$9.55	$10.96	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.70 / $69.18	Professional	TC	$21.88	$25.70	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $102.33	Professional		$66.07	$83.18	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $28.84	Professional	26	$18.20	$22.91	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $58.88 / $74.13	Professional	TC	$47.86	$58.88	$74.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $45.71 / $87.10	Professional		$33.11	$45.71	$87.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.98 / $93.33	Professional	26	$10.72	$16.98	$93.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $208.93	Professional	TC	$19.95	$30.90	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $74.13 / $74.13	Professional		$67.61	$74.13	$74.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $21.38 / $26.30	Professional	26	$20.42	$21.38	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $48.98 / $52.48	Professional	TC	$46.77	$48.98	$52.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.39 / $22.39	Professional	26	$22.39	$22.39	$22.39
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	TC	$47.86	$47.86	$47.86
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $54.95 / $67.61	Professional		$40.74	$54.95	$67.61
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.98 / $19.95	Professional	26	$12.59	$16.98	$19.95
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $35.48 / $47.86	Professional	TC	$27.54	$35.48	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $75.86	Professional		$36.31	$51.29	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $18.20 / $23.44	Professional	26	$10.72	$18.20	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.88 / $51.29	Professional	TC	$23.44	$33.88	$51.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $69.18 / $69.18	Professional		$58.88	$69.18	$69.18
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.42 / $20.42	Professional	26	$16.98	$20.42	$20.42
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $50.12 / $50.12	Professional	TC	$42.66	$50.12	$50.12