Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $123.03	Professional		$25.70	$38.90	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $30.90	Professional	26	$7.94	$10.00	$30.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $32.36 / $33.88	Professional	52	$30.20	$32.36	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $47.86	Professional	TC	$16.98	$22.91	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $85.11	Professional		$54.95	$67.61	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $20.42 / $25.70	Professional	26	$16.60	$20.42	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $47.86 / $58.88	Professional	TC	$38.02	$47.86	$58.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $100.00	Professional		$30.20	$46.77	$100.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.79 / $29.51	Professional	26	$10.23	$14.79	$29.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $34.67 / $204.17	Professional	TC	$23.99	$34.67	$204.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $61.66 / $83.18	Professional		$56.23	$61.66	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $19.05 / $24.55	Professional	26	$18.20	$19.05	$24.55
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $42.66 / $57.54	Professional	TC	$38.02	$42.66	$57.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	26	$19.50	$19.50	$19.50
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	TC	$44.67	$44.67	$44.67
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $60.26	Professional		$37.15	$48.98	$60.26
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $15.49 / $18.20	Professional	26	$11.22	$15.49	$18.20
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $35.48 / $41.69	Professional	TC	$25.70	$35.48	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $81.28	Professional		$34.67	$56.23	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.98 / $22.91	Professional	26	$10.23	$16.98	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.90 / $56.23	Professional	TC	$23.99	$38.90	$56.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $58.88	Professional		$50.12	$58.88	$58.88
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.20 / $18.20	Professional	26	$15.49	$18.20	$18.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $40.74 / $40.74	Professional	TC	$34.67	$40.74	$40.74