Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.45 / $13.45 / $13.45	Facility	26	$13.45	$13.45	$13.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $53.98 / $127.27	Professional		$36.00	$53.98	$127.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.63 / $13.40 / $49.84	Professional	26	$11.63	$13.40	$49.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.67 / $49.20 / $127.27	Professional	TC	$36.67	$49.20	$127.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.45 / $142.72 / $178.41	Professional		$114.45	$142.72	$178.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.74 / $30.25 / $37.82	Professional	26	$24.74	$30.25	$37.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.82 / $112.48 / $140.60	Professional	TC	$83.82	$112.48	$140.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $103.50 / $379.94	Professional		$62.10	$103.50	$379.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.62 / $25.62 / $83.23	Professional	26	$16.62	$25.62	$83.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.96 / $74.94 / $296.70	Professional	TC	$44.96	$74.94	$296.70
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $60.57 / $60.57 / $60.57	Facility	26	$60.57	$60.57	$60.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $98.67 / $118.57 / $148.93	Professional		$98.67	$118.57	$148.93
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $65.30 / $100.08 / $117.74	Professional		$65.30	$100.08	$117.74
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.42 / $22.70 / $25.88	Professional	26	$14.42	$22.70	$25.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.10 / $78.09 / $91.86	Professional	TC	$47.10	$78.09	$91.86
United Facility/Professional Professional Modifier Low / Median / High Price $64.11 / $101.16 / $109.93	Professional		$64.11	$101.16	$109.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.58 / $21.52 / $28.56	Professional	26	$15.58	$21.52	$28.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.77 / $63.70 / $78.69	Professional	TC	$48.77	$63.70	$78.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $103.90 / $122.20 / $122.20	Professional		$103.90	$122.20	$122.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $22.80 / $26.90 / $26.90	Professional	26	$22.80	$26.90	$26.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $81.09 / $95.40 / $95.40	Professional	TC	$81.09	$95.40	$95.40