Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.66 / $15.66 / $15.66	Facility	26	$15.66	$15.66	$15.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $48.42 / $83.80	Professional		$44.88	$48.42	$83.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $17.01 / $35.60	Professional	26	$13.26	$17.01	$35.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $36.75 / $96.30	Professional	TC	$31.62	$36.75	$96.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.79 / $117.13 / $146.41	Professional		$95.79	$117.13	$146.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.55 / $34.90 / $43.63	Professional	26	$28.55	$34.90	$43.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.92 / $82.22 / $102.78	Professional	TC	$65.92	$82.22	$102.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.48 / $89.14 / $321.19	Professional		$53.48	$89.14	$321.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.22 / $29.62 / $128.79	Professional	26	$19.22	$29.62	$128.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $34.20 / $58.71 / $254.00	Professional	TC	$34.20	$58.71	$254.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $49.41 / $49.41 / $49.41	Facility	26	$49.41	$49.41	$49.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $103.32 / $124.91	Professional		$80.00	$103.32	$124.91
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $52.78 / $72.56 / $97.04	Professional		$52.78	$72.56	$97.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $26.10 / $29.76	Professional	26	$19.30	$26.10	$29.76
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.45 / $50.16 / $67.28	Professional	TC	$34.45	$50.16	$67.28
United Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $72.34 / $90.22	Professional		$58.36	$72.34	$90.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.68 / $24.95 / $32.14	Professional	26	$17.68	$24.95	$32.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $47.39 / $60.35	Professional	TC	$37.11	$47.39	$60.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $100.80 / $100.80	Professional		$85.60	$100.80	$100.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.90 / $30.90	Professional	26	$26.30	$30.90	$30.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $59.40 / $69.90 / $69.90	Professional	TC	$59.40	$69.90	$69.90