Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.24 / $9.24 / $9.24	Facility	26	$9.24	$9.24	$9.24
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.37 / $25.37 / $223.35	Facility	TC	$25.37	$25.37	$223.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $29.61 / $56.11	Professional		$26.78	$29.61	$56.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.99 / $8.83 / $21.07	Professional	26	$7.99	$8.83	$21.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $21.62 / $67.64	Professional	TC	$19.71	$21.62	$67.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.44 / $77.56 / $96.96	Professional		$63.44	$77.56	$96.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $20.17 / $25.21	Professional	26	$16.48	$20.17	$25.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.92 / $57.40 / $71.75	Professional	TC	$44.92	$57.40	$71.75
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $190.34 / $190.34 / $190.34	Facility	TC	$190.34	$190.34	$190.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $58.57 / $208.77	Professional		$35.20	$58.57	$208.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.36 / $17.61 / $57.45	Professional	26	$11.36	$17.61	$57.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.29 / $40.47 / $151.32	Professional	TC	$24.29	$40.47	$151.32
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $39.90 / $39.90 / $39.90	Facility	26	$39.90	$39.90	$39.90
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $82.68 / $82.68 / $82.68	Facility	TC	$82.68	$82.68	$82.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $68.36 / $82.86	Professional		$56.81	$68.36	$82.86
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $54.99 / $64.69	Professional		$37.61	$54.99	$64.69
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $15.32 / $17.47	Professional	26	$9.73	$15.32	$17.47
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.40 / $40.14 / $47.22	Professional	TC	$24.40	$40.14	$47.22
United Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $58.57 / $93.58	Professional		$37.99	$58.57	$93.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.79 / $15.16 / $18.94	Professional	26	$10.79	$15.16	$18.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.64 / $34.40 / $40.96	Professional	TC	$25.64	$34.40	$40.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $57.10 / $67.20 / $67.20	Professional		$57.10	$67.20	$67.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.40 / $18.10 / $18.10	Professional	26	$15.40	$18.10	$18.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $41.70 / $49.00 / $49.00	Professional	TC	$41.70	$49.00	$49.00