Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.31 / $15.31 / $15.31	Facility	26	$15.31	$15.31	$15.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $61.46 / $87.24	Professional		$37.00	$61.46	$87.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $15.31 / $24.96	Professional	26	$13.26	$15.31	$24.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $47.07 / $68.17	Professional	TC	$23.74	$47.07	$68.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $96.19 / $120.23	Professional		$78.66	$96.19	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.91 / $34.13 / $42.66	Professional	26	$27.91	$34.13	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.57 / $62.06 / $77.56	Professional	TC	$49.57	$62.06	$77.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.30 / $74.61 / $390.88	Professional		$45.30	$74.61	$390.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.22 / $29.62 / $103.00	Professional	26	$19.22	$29.62	$103.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.02 / $43.77 / $301.75	Professional	TC	$26.02	$43.77	$301.75
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 $77.25 / $87.71 / $108.37	Professional		$77.25	$87.71	$108.37
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.08 / $68.19 / $80.22	Professional		$46.08	$68.19	$80.22
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $25.53 / $29.11	Professional	26	$19.30	$25.53	$29.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.77 / $43.44 / $51.11	Professional	TC	$26.77	$43.44	$51.11
United Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $64.18 / $76.40	Professional		$48.40	$64.18	$76.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $26.25 / $32.68	Professional	26	$17.98	$26.25	$32.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.18 / $35.31 / $44.99	Professional	TC	$29.18	$35.31	$44.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.80 / $83.30 / $83.30	Professional		$70.80	$83.30	$83.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.20 / $30.20	Professional	26	$25.70	$30.20	$30.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $45.10 / $53.10 / $53.10	Professional	TC	$45.10	$53.10	$53.10