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 Facility Modifier TC Low / Median / High Price $25.12 / $36.31 / $223.87	Facility	TC	$25.12	$36.31	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $33.88 / $75.86	Professional		$8.51	$33.88	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.91 / $26.30	Professional	26	$7.94	$8.91	$26.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.70 / $67.61	Professional	TC	$20.89	$25.70	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $79.43 / $100.00	Professional		$63.10	$79.43	$100.00
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 $46.77 / $58.88 / $74.13	Professional	TC	$46.77	$58.88	$74.13
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $190.55 / $190.55 / $190.55	Facility	TC	$190.55	$190.55	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $74.13	Professional		$31.62	$44.67	$74.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $14.13 / $26.30	Professional	26	$9.55	$14.13	$26.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $57.54	Professional	TC	$20.42	$30.20	$57.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $67.61 / $70.79	Professional		$64.57	$67.61	$70.79
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $19.05 / $21.88	Professional	26	$18.20	$19.05	$21.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $46.77 / $52.48	Professional	TC	$45.71	$46.77	$52.48
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 $45.71 / $45.71 / $45.71	Professional	TC	$45.71	$45.71	$45.71
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $64.57	Professional		$36.31	$53.70	$64.57
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.49 / $17.38	Professional	26	$10.72	$15.49	$17.38
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.81 / $46.77	Professional	TC	$25.70	$39.81	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $74.13	Professional		$33.11	$47.86	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.14 / $20.42	Professional	26	$10.47	$15.14	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $52.48	Professional	TC	$22.39	$32.36	$52.48
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 $15.49 / $18.20 / $18.20	Professional	26	$15.49	$18.20	$18.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $48.98 / $48.98	Professional	TC	$41.69	$48.98	$48.98