Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.79 / $6.79 / $6.79	Facility	26	$6.79	$6.79	$6.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.19 / $107.60 / $242.32	Facility	TC	$33.19	$107.60	$242.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6.56 / $34.45 / $105.91	Professional		$6.56	$34.45	$105.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $10.24 / $46.28	Professional	26	$6.21	$10.24	$46.28
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.23 / $17.23 / $19.98	Professional	52	$17.23	$17.23	$19.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.13 / $52.89 / $160.19	Professional	TC	$28.13	$52.89	$160.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.90 / $89.21 / $111.51	Professional		$72.90	$89.21	$111.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.05 / $14.74 / $18.42	Professional	26	$12.05	$14.74	$18.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.09 / $74.47 / $93.08	Professional	TC	$58.09	$74.47	$93.08
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $310.18 / $310.18 / $310.18	Facility	TC	$310.18	$310.18	$310.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.81 / $64.13 / $241.48	Professional		$37.81	$64.13	$241.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.35 / $12.94 / $51.19	Professional	26	$8.35	$12.94	$51.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.46 / $51.55 / $199.06	Professional	TC	$29.46	$51.55	$199.06
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $22.00 / $22.00 / $22.00	Facility	26	$22.00	$22.00	$22.00
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $85.63 / $85.63 / $85.63	Facility	TC	$85.63	$85.63	$85.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $74.23 / $95.32	Professional		$41.00	$74.23	$95.32
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.93 / $55.46 / $74.39	Professional		$37.93	$55.46	$74.39
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $11.35 / $12.94	Professional	26	$8.38	$11.35	$12.94
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.71 / $45.82 / $61.46	Professional	TC	$29.71	$45.82	$61.46
United Facility/Professional Professional Modifier Low / Median / High Price $41.11 / $63.02 / $69.47	Professional		$41.11	$63.02	$69.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $12.94 / $13.92	Professional	26	$8.00	$12.94	$13.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.36 / $51.55 / $52.98	Professional	TC	$34.36	$51.55	$52.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $65.70 / $77.20 / $77.20	Professional		$65.70	$77.20	$77.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $13.40 / $13.40	Professional	26	$11.40	$13.40	$13.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $54.20 / $63.80 / $63.80	Professional	TC	$54.20	$63.80	$63.80