Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.99 / $10.99 / $10.99	Facility	26	$10.99	$10.99	$10.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.58 / $52.17 / $72.01	Professional		$36.58	$52.17	$72.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $14.03 / $38.70	Professional	26	$10.45	$14.03	$38.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.08 / $41.42 / $83.66	Professional	TC	$27.08	$41.42	$83.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $94.64 / $118.29	Professional		$77.39	$94.64	$118.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.67 / $24.05 / $30.06	Professional	26	$19.67	$24.05	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.59 / $70.59 / $88.24	Professional	TC	$57.59	$70.59	$88.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $73.26 / $262.94	Professional		$47.52	$73.26	$262.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $20.94 / $117.24	Professional	26	$13.53	$20.94	$117.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.44 / $52.32 / $201.73	Professional	TC	$33.44	$52.32	$201.73
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $38.94 / $38.94 / $38.94	Facility	26	$38.94	$38.94	$38.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.25 / $86.95 / $105.14	Professional		$77.25	$86.95	$105.14
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $49.09 / $66.66 / $78.92	Professional		$49.09	$66.66	$78.92
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.78 / $18.16 / $20.70	Professional	26	$13.78	$18.16	$20.70
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $35.32 / $48.44 / $58.22	Professional	TC	$35.32	$48.44	$58.22
United Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $71.28 / $80.95	Professional		$47.52	$71.28	$80.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $20.94 / $23.67	Professional	26	$12.78	$20.94	$23.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.94 / $46.74 / $58.42	Professional	TC	$33.94	$46.74	$58.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.70 / $81.90 / $81.90	Professional		$69.70	$81.90	$81.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $21.50 / $21.50	Professional	26	$18.30	$21.50	$21.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $51.40 / $60.50 / $60.50	Professional	TC	$51.40	$60.50	$60.50