Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.09 / $13.09 / $13.09	Facility	26	$13.09	$13.09	$13.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.11 / $32.11 / $296.58	Facility	TC	$32.11	$32.11	$296.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.09 / $38.70 / $71.67	Professional		$38.09	$38.70	$71.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $12.66 / $19.78	Professional	26	$11.32	$12.66	$19.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.42 / $27.38 / $51.90	Professional	TC	$25.42	$27.38	$51.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $99.29 / $124.11	Professional		$81.20	$99.29	$124.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.47 / $28.70 / $35.88	Professional	26	$23.47	$28.70	$35.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.08 / $70.59 / $88.24	Professional	TC	$57.08	$70.59	$88.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.57 / $77.27 / $277.95	Professional		$46.57	$77.27	$277.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.19 / $24.96 / $81.06	Professional	26	$16.19	$24.96	$81.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $50.54 / $196.89	Professional	TC	$30.32	$50.54	$196.89
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $57.81 / $57.81 / $57.81	Facility	26	$57.81	$57.81	$57.81
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	TC	$105.26	$105.26	$105.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.28 / $88.86 / $108.09	Professional		$85.28	$88.86	$108.09
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $52.34 / $72.63 / $82.80	Professional		$52.34	$72.63	$82.80
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.06 / $21.56 / $24.58	Professional	26	$14.06	$21.56	$24.58
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.84 / $51.07 / $58.22	Professional	TC	$30.84	$51.07	$58.22
United Facility/Professional Professional Modifier Low / Median / High Price $46.60 / $62.10 / $77.66	Professional		$46.60	$62.10	$77.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $21.00 / $27.12	Professional	26	$14.92	$21.00	$27.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $41.10 / $53.06	Professional	TC	$32.40	$41.10	$53.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.09 / $86.00 / $86.00	Professional		$73.09	$86.00	$86.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $21.70 / $25.50 / $25.50	Professional	26	$21.70	$25.50	$25.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $51.40 / $60.50 / $60.50	Professional	TC	$51.40	$60.50	$60.50