Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.40 / $12.40 / $12.40	Facility	26	$12.40	$12.40	$12.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $43.61 / $70.66	Professional		$38.10	$43.61	$70.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $13.65 / $40.04	Professional	26	$10.44	$13.65	$40.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $35.11 / $92.70	Professional	TC	$27.38	$35.11	$92.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $97.74 / $122.17	Professional		$79.93	$97.74	$122.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.20 / $27.15 / $33.94	Professional	26	$22.20	$27.15	$33.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.86 / $70.59 / $88.24	Professional	TC	$56.86	$70.59	$88.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.31 / $75.28 / $271.52	Professional		$45.31	$75.28	$271.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $22.91 / $97.41	Professional	26	$13.09	$22.91	$97.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $51.67 / $210.00	Professional	TC	$32.47	$51.67	$210.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $36.65 / $36.65 / $36.65	Facility	26	$36.65	$36.65	$36.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $88.14 / $105.69	Professional		$65.00	$88.14	$105.69
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $45.91 / $63.12 / $81.51	Professional		$45.91	$63.12	$81.51
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $18.88 / $23.29	Professional	26	$13.36	$18.88	$23.29
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.18 / $44.24 / $58.22	Professional	TC	$32.18	$44.24	$58.22
United Facility/Professional Professional Modifier Low / Median / High Price $48.83 / $75.28 / $92.79	Professional		$48.83	$75.28	$92.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.25 / $19.84 / $23.61	Professional	26	$14.25	$19.84	$23.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $50.27 / $59.06	Professional	TC	$32.47	$50.27	$59.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $71.90 / $84.60 / $84.60	Professional		$71.90	$84.60	$84.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $24.20 / $24.20	Professional	26	$20.60	$24.20	$24.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $51.40 / $60.50 / $60.50	Professional	TC	$51.40	$60.50	$60.50