Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.67 / $17.67 / $17.67	Facility	26	$17.67	$17.67	$17.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.68 / $71.72 / $135.71	Professional		$65.68	$71.72	$135.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.26 / $17.67 / $60.52	Professional	26	$15.26	$17.67	$60.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.39 / $54.32 / $109.00	Professional	TC	$49.39	$54.32	$109.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.60 / $188.50 / $235.62	Professional		$152.60	$188.50	$235.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.72 / $38.79 / $48.48	Professional	26	$31.72	$38.79	$48.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.00 / $149.71 / $187.14	Professional	TC	$113.00	$149.71	$187.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.48 / $142.33 / $507.76	Professional		$81.48	$142.33	$507.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.01 / $33.86 / $109.02	Professional	26	$21.01	$33.86	$109.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.47 / $100.78 / $398.67	Professional	TC	$60.47	$100.78	$398.67
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $70.25 / $70.25 / $70.25	Facility	26	$70.25	$70.25	$70.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $129.44 / $169.98 / $199.37	Professional		$129.44	$169.98	$199.37
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $93.41 / $131.97 / $155.26	Professional		$93.41	$131.97	$155.26
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $28.70 / $32.99	Professional	26	$18.73	$28.70	$32.99
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $63.03 / $103.93 / $122.26	Professional	TC	$63.03	$103.93	$122.26
United Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $135.80 / $146.28	Professional		$87.56	$135.80	$146.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $28.40 / $35.02	Professional	26	$20.38	$28.40	$35.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.26 / $88.35 / $112.41	Professional	TC	$66.26	$88.35	$112.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $161.19 / $161.19	Professional		$137.00	$161.19	$161.19
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $34.29 / $34.29	Professional	26	$29.10	$34.29	$34.29
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $107.90 / $127.00 / $127.00	Professional	TC	$107.90	$127.00	$127.00