Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.32 / $15.32 / $15.32	Facility	26	$15.32	$15.32	$15.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.86 / $55.78 / $104.72	Professional		$54.86	$55.78	$104.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.16 / $15.87 / $56.07	Professional	26	$14.16	$15.87	$56.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.85 / $75.16 / $137.69	Professional	TC	$39.85	$75.16	$137.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.26 / $145.83 / $182.29	Professional		$119.26	$145.83	$182.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.91 / $34.13 / $42.66	Professional	26	$27.91	$34.13	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.21 / $111.70 / $139.63	Professional	TC	$88.21	$111.70	$139.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.02 / $109.98 / $395.03	Professional		$66.02	$109.98	$395.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.21 / $29.62 / $93.99	Professional	26	$19.21	$29.62	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $48.84 / $80.36 / $301.02	Professional	TC	$48.84	$80.36	$301.02
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $67.92 / $67.92 / $67.92	Facility	26	$67.92	$67.92	$67.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $129.81 / $154.91	Professional		$108.36	$129.81	$154.91
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $102.28 / $120.32	Professional		$71.34	$102.28	$120.32
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $25.53 / $29.11	Professional	26	$16.57	$25.53	$29.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.78 / $77.54 / $91.21	Professional	TC	$47.78	$77.54	$91.21
United Facility/Professional Professional Modifier Low / Median / High Price $68.12 / $109.98 / $137.06	Professional		$68.12	$109.98	$137.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $29.62 / $40.18	Professional	26	$17.98	$29.62	$40.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.84 / $63.15 / $81.40	Professional	TC	$48.84	$63.15	$81.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $106.20 / $124.90 / $124.90	Professional		$106.20	$124.90	$124.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.20 / $30.20	Professional	26	$25.70	$30.20	$30.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $80.50 / $94.70 / $94.70	Professional	TC	$80.50	$94.70	$94.70