Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $7.94 / $7.94	Facility	26	$7.94	$7.94	$7.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $21.88 / $32.36	Facility	TC	$21.88	$21.88	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.90 / $87.10	Professional		$24.55	$30.90	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.91 / $29.51	Professional	26	$7.08	$8.91	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $22.91 / $58.88	Professional	TC	$19.05	$22.91	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $89.13	Professional		$56.23	$70.79	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $18.20 / $22.91	Professional	26	$14.45	$18.20	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $52.48 / $66.07	Professional	TC	$41.69	$52.48	$66.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $41.69 / $69.18	Professional		$28.18	$41.69	$69.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.59 / $23.44	Professional	26	$8.32	$12.59	$23.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $29.51 / $54.95	Professional	TC	$19.50	$29.51	$54.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $63.10 / $63.10	Professional		$57.54	$63.10	$63.10
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.98 / $19.50	Professional	26	$16.22	$16.98	$19.50
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $43.65 / $46.77	Professional	TC	$40.74	$43.65	$46.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $17.38 / $17.38	Professional	26	$17.38	$17.38	$17.38
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $42.66 / $42.66	Professional	TC	$42.66	$42.66	$42.66
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $57.54	Professional		$33.88	$47.86	$57.54
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.49 / $15.49	Professional	26	$9.33	$13.49	$15.49
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $41.69	Professional	TC	$23.99	$35.48	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $66.07	Professional		$30.90	$44.67	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.49 / $18.20	Professional	26	$9.33	$13.49	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.90 / $48.98	Professional	TC	$21.38	$30.90	$48.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $60.26 / $60.26	Professional		$51.29	$60.26	$60.26
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.22 / $16.22	Professional	26	$13.80	$16.22	$16.22
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $43.65	Professional	TC	$37.15	$43.65	$43.65