Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $295.12 / $446.68	Facility		$100.00	$295.12	$446.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $7.08 / $7.08	Facility	26	$7.08	$7.08	$7.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $245.47 / $295.12	Facility	TC	$25.12	$245.47	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $31.62 / $81.28	Professional		$8.32	$31.62	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $13.80 / $37.15	Professional	26	$7.24	$13.80	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $56.23 / $199.53	Professional	50	$52.48	$56.23	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $36.31 / $72.44	Professional	TC	$21.88	$36.31	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $93.33	Professional		$60.26	$75.86	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $17.38 / $21.88	Professional	26	$13.80	$17.38	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $57.54 / $72.44	Professional	TC	$46.77	$57.54	$72.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $46.77 / $213.80	Facility		$33.88	$46.77	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $42.66 / $81.28	Professional		$29.51	$42.66	$81.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.13 / $29.51	Professional	26	$8.71	$14.13	$29.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $32.36 / $162.18	Professional	TC	$20.42	$32.36	$162.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $64.57 / $67.61	Professional		$61.66	$64.57	$67.61
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $16.22 / $18.62	Professional	26	$15.49	$16.22	$18.62
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $46.77 / $51.29	Professional	TC	$45.71	$46.77	$51.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Professional	26	$16.60	$16.60	$16.60
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $45.71 / $45.71	Professional	TC	$45.71	$45.71	$45.71
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $45.71 / $61.66	Professional		$33.11	$45.71	$61.66
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $13.18 / $14.79	Professional	26	$9.55	$13.18	$14.79
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $46.77	Professional	TC	$22.91	$33.88	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $46.77 / $69.18	Professional		$31.62	$46.77	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.80 / $18.20	Professional	26	$8.71	$13.80	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $50.12	Professional	TC	$22.39	$33.11	$50.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $63.10 / $63.10	Professional		$53.70	$63.10	$63.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $15.49 / $15.49	Professional	26	$13.18	$15.49	$15.49
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $47.86	Professional	TC	$40.74	$47.86	$47.86