Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.32 / $15.32 / $15.32	Facility	26	$15.32	$15.32	$15.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.53 / $63.35 / $119.21	Professional		$60.53	$63.35	$119.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $21.34 / $56.07	Professional	26	$13.26	$21.34	$56.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.50 / $58.91 / $161.09	Professional	TC	$45.50	$58.91	$161.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.12 / $165.22 / $206.53	Professional		$135.12	$165.22	$206.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.91 / $34.13 / $42.66	Professional	26	$27.91	$34.13	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.08 / $131.09 / $163.87	Professional	TC	$104.08	$131.09	$163.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.01 / $125.02 / $453.03	Professional		$75.01	$125.02	$453.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.28 / $29.88 / $95.54	Professional	26	$19.28	$29.88	$95.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $55.73 / $92.88 / $357.49	Professional	TC	$55.73	$92.88	$357.49
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $64.64 / $64.64 / $64.64	Facility	26	$64.64	$64.64	$64.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $119.11 / $143.88 / $177.81	Professional		$119.11	$143.88	$177.81
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $79.14 / $116.03 / $136.50	Professional		$79.14	$116.03	$136.50
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $25.53 / $29.11	Professional	26	$16.57	$25.53	$29.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $56.25 / $91.28 / $107.39	Professional	TC	$56.25	$91.28	$107.39
United Facility/Professional Professional Modifier Low / Median / High Price $81.47 / $122.20 / $127.65	Professional		$81.47	$122.20	$127.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $25.72 / $32.14	Professional	26	$17.98	$25.72	$32.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.13 / $78.95 / $95.72	Professional	TC	$59.13	$78.95	$95.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.50 / $141.69 / $141.69	Professional		$120.50	$141.69	$141.69
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.20 / $30.20	Professional	26	$25.70	$30.20	$30.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $94.80 / $111.50 / $111.50	Professional	TC	$94.80	$111.50	$111.50