Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.83 / $7.83 / $7.83	Facility	26	$7.83	$7.83	$7.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.80 / $28.12 / $58.74	Professional		$17.80	$28.12	$58.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $14.66 / $28.80	Professional	26	$7.24	$14.66	$28.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.84 / $12.84 / $15.00	Professional	52	$12.84	$12.84	$15.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.43 / $42.26 / $113.40	Professional	TC	$20.43	$42.26	$113.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.92 / $65.93 / $82.42	Professional		$53.92	$65.93	$82.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $17.07 / $21.33	Professional	26	$13.96	$17.07	$21.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.97 / $48.87 / $61.09	Professional	TC	$39.97	$48.87	$61.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $51.89 / $184.96	Professional		$31.19	$51.89	$184.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $14.93 / $67.13	Professional	26	$9.65	$14.93	$67.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.56 / $36.96 / $149.00	Professional	TC	$22.56	$36.96	$149.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.57 / $25.57 / $25.57	Facility	26	$25.57	$25.57	$25.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $59.61 / $72.06	Professional		$47.00	$59.61	$72.06
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $32.18 / $44.24 / $54.99	Professional		$32.18	$44.24	$54.99
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $13.05 / $14.88	Professional	26	$9.86	$13.05	$14.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.31 / $30.67 / $40.11	Professional	TC	$22.31	$30.67	$40.11
United Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $41.58 / $53.68	Professional		$29.52	$41.58	$53.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $12.86 / $16.07	Professional	26	$9.19	$12.86	$16.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.56 / $30.08 / $39.47	Professional	TC	$22.56	$30.08	$39.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $48.50 / $57.10 / $57.10	Professional		$48.50	$57.10	$57.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $15.40 / $15.40	Professional	26	$13.10	$15.40	$15.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $41.60 / $41.60	Professional	TC	$35.40	$41.60	$41.60