Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $7.94 / $7.94	Facility	26	$7.94	$7.94	$7.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $34.67 / $100.00	Professional		$29.51	$34.67	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.91 / $26.92	Professional	26	$7.08	$8.91	$26.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.70 / $42.66	Professional	TC	$21.88	$25.70	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $100.00	Professional		$64.57	$79.43	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.05 / $23.99	Professional	26	$15.14	$19.05	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $61.66 / $75.86	Professional	TC	$48.98	$61.66	$75.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $42.66 / $79.43	Professional		$30.90	$42.66	$79.43
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.80 / $24.55	Professional	26	$8.71	$13.80	$24.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $158.49	Professional	TC	$19.95	$30.90	$158.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $67.61 / $72.44	Professional		$64.57	$67.61	$72.44
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $17.78 / $20.42	Professional	26	$16.22	$17.78	$20.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $48.98 / $53.70	Professional	TC	$47.86	$48.98	$53.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Professional		$66.07	$66.07	$66.07
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.20 / $18.20	Professional	26	$18.20	$18.20	$18.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	TC	$47.86	$47.86	$47.86
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $66.07	Professional		$33.88	$46.77	$66.07
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.80 / $16.22	Professional	26	$10.00	$13.80	$16.22
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $48.98	Professional	TC	$25.70	$33.88	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $47.86 / $70.79	Professional		$30.90	$47.86	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.79 / $19.05	Professional	26	$8.71	$14.79	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.88 / $48.98	Professional	TC	$21.88	$33.88	$48.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $67.61	Professional		$57.54	$67.61	$67.61
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.98 / $16.98	Professional	26	$14.45	$16.98	$16.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $51.29 / $51.29	Professional	TC	$43.65	$51.29	$51.29