Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.35 / $11.35 / $11.35	Facility	26	$11.35	$11.35	$11.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.81 / $395.57 / $769.64	Facility	TC	$37.81	$395.57	$769.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.57 / $55.18 / $227.84	Professional		$16.57	$55.18	$227.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $21.20 / $56.70	Professional	26	$10.53	$21.20	$56.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $588.25 / $588.25 / $588.25	Professional	50	$588.25	$588.25	$588.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.32 / $21.32 / $24.58	Professional	52	$21.32	$21.32	$24.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.57 / $70.98 / $240.30	Professional	TC	$31.57	$70.98	$240.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.67 / $110.93 / $138.66	Professional		$89.67	$110.93	$138.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $24.82 / $31.03	Professional	26	$20.30	$24.82	$31.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.92 / $86.10 / $107.63	Professional	TC	$65.92	$86.10	$107.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.71 / $79.52 / $297.63	Professional		$47.71	$79.52	$297.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $20.94 / $87.52	Professional	26	$13.52	$20.94	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $34.19 / $58.69 / $229.42	Professional	TC	$34.19	$58.69	$229.42
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $38.79 / $38.79 / $38.79	Facility	26	$38.79	$38.79	$38.79
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $105.86 / $105.86 / $105.86	Facility	TC	$105.86	$105.86	$105.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $92.12 / $116.89	Professional		$64.00	$92.12	$116.89
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $48.06 / $68.48 / $91.86	Professional		$48.06	$68.48	$91.86
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.78 / $18.72 / $21.35	Professional	26	$13.78	$18.72	$21.35
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.45 / $52.57 / $70.51	Professional	TC	$34.45	$52.57	$70.51
United Facility/Professional Professional Modifier Low / Median / High Price $48.74 / $64.98 / $81.27	Professional		$48.74	$64.98	$81.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $17.57 / $23.67	Professional	26	$13.18	$17.57	$23.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $47.41 / $60.33	Professional	TC	$37.11	$47.41	$60.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.09 / $95.40 / $95.40	Professional		$81.09	$95.40	$95.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $22.20 / $22.20	Professional	26	$18.80	$22.20	$22.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $62.20 / $73.20 / $73.20	Professional	TC	$62.20	$73.20	$73.20