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 $35.00 / $35.36 / $66.17	Professional		$35.00	$35.36	$66.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $11.52 / $32.93	Professional	26	$8.73	$11.52	$32.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.86 / $30.35 / $80.09	Professional	TC	$25.86	$30.35	$80.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.86 / $91.53 / $114.42	Professional		$74.86	$91.53	$114.42
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 $53.95 / $67.48 / $84.36	Professional	TC	$53.95	$67.48	$84.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.53 / $68.69 / $252.05	Professional		$39.53	$68.69	$252.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $19.89 / $97.41	Professional	26	$11.37	$19.89	$97.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.16 / $47.66 / $183.85	Professional	TC	$28.16	$47.66	$183.85
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $29.42 / $29.42 / $29.42	Facility	26	$29.42	$29.42	$29.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $77.04 / $98.48	Professional		$61.00	$77.04	$98.48
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.99 / $56.91 / $76.33	Professional		$39.99	$56.91	$76.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.63 / $15.93 / $20.70	Professional	26	$11.63	$15.93	$20.70
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.43 / $41.48 / $55.63	Professional	TC	$28.43	$41.48	$55.63
United Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $56.64 / $71.17	Professional		$42.97	$56.64	$71.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $18.16 / $21.61	Professional	26	$12.39	$18.16	$21.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.58 / $38.47 / $48.99	Professional	TC	$30.58	$38.47	$48.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $79.30 / $79.30	Professional		$67.40	$79.30	$79.30
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 $49.10 / $57.80 / $57.80	Professional	TC	$49.10	$57.80	$57.80