Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.00 / $10.00	Facility	26	$10.00	$10.00	$10.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $93.33	Professional		$36.31	$51.29	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $38.90	Professional	26	$10.00	$16.22	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $83.18	Professional	TC	$26.92	$41.69	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $97.72 / $120.23	Professional		$77.62	$97.72	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $24.55 / $30.90	Professional	26	$19.50	$24.55	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $72.44 / $91.20	Professional	TC	$57.54	$72.44	$91.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $58.88 / $114.82	Professional		$38.90	$58.88	$114.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $17.78 / $31.62	Professional	26	$10.72	$17.78	$31.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $40.74 / $199.53	Professional	TC	$29.51	$40.74	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $87.10 / $95.50	Professional		$79.43	$87.10	$95.50
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $22.91 / $26.30	Professional	26	$21.38	$22.91	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $64.57 / $69.18	Professional	TC	$57.54	$64.57	$69.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.44	Professional	26	$23.44	$23.44	$23.44
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	TC	$57.54	$57.54	$57.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $66.07 / $79.43	Professional		$50.12	$66.07	$79.43
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $18.20 / $20.89	Professional	26	$13.18	$18.20	$20.89
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $48.98 / $58.88	Professional	TC	$36.31	$48.98	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $69.18 / $89.13	Professional		$43.65	$69.18	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $18.20 / $24.55	Professional	26	$11.48	$18.20	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $50.12 / $67.61	Professional	TC	$32.36	$50.12	$67.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $81.28	Professional		$69.18	$81.28	$81.28
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $21.38 / $21.38	Professional	26	$18.20	$21.38	$21.38
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $60.26 / $60.26	Professional	TC	$51.29	$60.26	$60.26