Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.75 / $12.75 / $12.75	Facility	26	$12.75	$12.75	$12.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.38 / $38.40 / $72.31	Professional		$37.38	$38.40	$72.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.36 / $19.27 / $45.39	Professional	26	$12.36	$19.27	$45.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.01 / $32.11 / $84.55	Professional	TC	$25.01	$32.11	$84.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.83 / $100.07 / $125.08	Professional		$81.83	$100.07	$125.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $27.93 / $34.90	Professional	26	$22.84	$27.93	$34.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.08 / $72.14 / $90.18	Professional	TC	$57.08	$72.14	$90.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.54 / $77.27 / $273.64	Professional		$46.54	$77.27	$273.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.84 / $24.96 / $78.91	Professional	26	$15.84	$24.96	$78.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.76 / $51.26 / $194.73	Professional	TC	$30.76	$51.26	$194.73
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $53.41 / $53.41 / $53.41	Facility	26	$53.41	$53.41	$53.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $74.41 / $89.58 / $106.88	Professional		$74.41	$89.58	$106.88
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $49.30 / $70.94 / $83.45	Professional		$49.30	$70.94	$83.45
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.06 / $20.99 / $23.94	Professional	26	$14.06	$20.99	$23.94
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.84 / $50.59 / $59.51	Professional	TC	$30.84	$50.59	$59.51
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.27 / $95.02	Professional		$50.12	$77.27	$95.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.78 / $24.96 / $26.40	Professional	26	$14.78	$24.96	$26.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $50.90 / $55.92	Professional	TC	$32.40	$50.90	$55.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $86.60 / $86.60	Professional		$73.70	$86.60	$86.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $21.10 / $24.90 / $24.90	Professional	26	$21.10	$24.90	$24.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $52.50 / $61.80 / $61.80	Professional	TC	$52.50	$61.80	$61.80