Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.97 / $14.97 / $14.97	Facility	26	$14.97	$14.97	$14.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.17 / $75.26 / $106.67	Professional		$55.17	$75.26	$106.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $17.26 / $32.97	Professional	26	$12.65	$17.26	$32.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.52 / $57.99 / $80.86	Professional	TC	$42.52	$57.99	$80.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $143.50 / $179.38	Professional		$117.36	$143.50	$179.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.28 / $33.36 / $41.69	Professional	26	$27.28	$33.36	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.08 / $110.15 / $137.69	Professional	TC	$90.08	$110.15	$137.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $110.65 / $399.42	Professional		$71.77	$110.65	$399.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.35 / $28.29 / $151.90	Professional	26	$18.35	$28.29	$151.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $52.62 / $82.36 / $307.58	Professional	TC	$52.62	$82.36	$307.58
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $54.91 / $54.91 / $54.91	Facility	26	$54.91	$54.91	$54.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.00 / $129.11 / $154.91	Professional		$115.00	$129.11	$154.91
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $75.08 / $101.54 / $119.03	Professional		$75.08	$101.54	$119.03
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.71 / $24.97 / $28.46	Professional	26	$19.71	$24.97	$28.46
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $54.49 / $74.92 / $90.57	Professional	TC	$54.49	$74.92	$90.57
United Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $93.23 / $124.30	Professional		$71.77	$93.23	$124.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $28.29 / $34.51	Professional	26	$17.17	$28.29	$34.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.42 / $73.15 / $96.01	Professional	TC	$53.42	$73.15	$96.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $105.10 / $123.60 / $123.60	Professional		$105.10	$123.60	$123.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $25.10 / $29.60 / $29.60	Professional	26	$25.10	$29.60	$29.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $79.90 / $94.00 / $94.00	Professional	TC	$79.90	$94.00	$94.00