Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.34 / $11.34 / $11.34	Facility	26	$11.34	$11.34	$11.34
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.50 / $138.08 / $471.63	Facility	TC	$27.50	$138.08	$471.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.64 / $38.84 / $96.12	Professional		$32.64	$38.84	$96.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $10.97 / $27.32	Professional	26	$10.45	$10.97	$27.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $36.74 / $72.98	Professional	TC	$23.17	$36.74	$72.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.42 / $86.10 / $107.63	Professional		$70.42	$86.10	$107.63
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 $48.98 / $61.28 / $76.59	Professional	TC	$48.98	$61.28	$76.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.96 / $66.58 / $236.84	Professional		$39.96	$66.58	$236.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $21.61 / $40.50	Professional	26	$13.96	$21.61	$40.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.00 / $43.34 / $166.53	Professional	TC	$26.00	$43.34	$166.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $48.96 / $48.96 / $48.96	Facility	26	$48.96	$48.96	$48.96
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $90.41 / $90.41 / $90.41	Facility	TC	$90.41	$90.41	$90.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $73.63 / $77.36 / $92.95	Professional		$73.63	$77.36	$92.95
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $45.22 / $62.98 / $71.81	Professional		$45.22	$62.98	$71.81
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.89 / $18.72 / $21.35	Professional	26	$11.89	$18.72	$21.35
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $44.26 / $50.46	Professional	TC	$26.43	$44.26	$50.46
United Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $56.61 / $66.88	Professional		$43.19	$56.61	$66.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $19.77 / $23.26	Professional	26	$12.78	$19.77	$23.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.78 / $35.33 / $44.97	Professional	TC	$27.78	$35.33	$44.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.40 / $74.59 / $74.59	Professional		$63.40	$74.59	$74.59
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 $44.50 / $52.40 / $52.40	Professional	TC	$44.50	$52.40	$52.40