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 Professional Modifier Low / Median / High Price $34.67 / $44.67 / $100.00	Professional		$34.67	$44.67	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $29.51	Professional	26	$7.94	$10.96	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.90 / $87.10	Professional	TC	$28.18	$38.90	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $95.50 / $120.23	Professional		$75.86	$95.50	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.05 / $23.99	Professional	26	$15.14	$19.05	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $75.86 / $95.50	Professional	TC	$60.26	$75.86	$95.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $53.70 / $102.33	Professional		$35.48	$53.70	$102.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.49 / $30.90	Professional	26	$8.71	$13.49	$30.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $43.65 / $208.93	Professional	TC	$25.70	$43.65	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $85.11	Professional		$77.62	$83.18	$85.11
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $17.78 / $20.42	Professional	26	$16.22	$17.78	$20.42
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $61.66 / $67.61	Professional	TC	$61.66	$61.66	$67.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.20 / $18.20	Professional	26	$18.20	$18.20	$18.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $61.66 / $61.66	Professional	TC	$61.66	$61.66	$61.66
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $57.54 / $77.62	Professional		$38.90	$57.54	$77.62
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.13 / $16.22	Professional	26	$10.47	$14.13	$16.22
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $45.71 / $61.66	Professional	TC	$28.18	$45.71	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $89.13	Professional		$39.81	$60.26	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.79 / $19.50	Professional	26	$8.71	$14.79	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $43.65 / $67.61	Professional	TC	$29.51	$43.65	$67.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $81.28	Professional		$69.18	$81.28	$81.28
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.98 / $16.98	Professional	26	$14.45	$16.98	$16.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.10 / $63.10	Professional	TC	$53.70	$63.10	$63.10