Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $104.71	Professional		$39.81	$50.12	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.14 / $51.29	Professional	26	$10.23	$15.14	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.11 / $81.28	Professional	TC	$25.12	$33.11	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $125.89	Professional		$81.28	$102.33	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.88 / $42.66	Professional	26	$23.99	$33.88	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $67.61 / $85.11	Professional	TC	$53.70	$67.61	$85.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $66.07 / $134.90	Professional		$40.74	$66.07	$134.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $16.98 / $213.80	Professional	26	$9.33	$16.98	$213.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $50.12 / $426.58	Professional	TC	$31.62	$50.12	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $91.20 / $104.71	Professional		$83.18	$91.20	$104.71
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $32.36 / $35.48	Professional	26	$29.51	$32.36	$35.48
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $60.26 / $69.18	Professional	TC	$53.70	$60.26	$69.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Professional	26	$32.36	$32.36	$32.36
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $53.70 / $53.70	Professional	TC	$53.70	$53.70	$53.70
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $77.62 / $138.04	Professional		$52.48	$77.62	$138.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.89 / $28.84	Professional	26	$10.96	$20.89	$28.84
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $54.95 / $125.89	Professional	TC	$34.67	$54.95	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $77.62 / $117.49	Professional		$46.77	$77.62	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $17.38 / $28.18	Professional	26	$10.23	$17.38	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $54.95 / $85.11	Professional	TC	$31.62	$54.95	$85.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $87.10	Professional		$74.13	$87.10	$87.10
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 $47.86 / $56.23 / $56.23	Professional	TC	$47.86	$56.23	$56.23