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 $16.98 / $39.81 / $79.43	Professional		$16.98	$39.81	$79.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $21.88 / $46.77	Professional	26	$12.88	$21.88	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $28.84 / $74.13	Professional	TC	$12.88	$28.84	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $102.33 / $128.82	Professional		$66.07	$102.33	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $34.67 / $43.65	Professional	26	$22.39	$34.67	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $67.61 / $85.11	Professional	TC	$42.66	$67.61	$85.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $37.15 / $79.43	Professional		$19.50	$37.15	$79.43
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $17.38 / $38.02	Professional	26	$9.55	$17.38	$38.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $18.20 / $724.44	Professional	TC	$10.00	$18.20	$724.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $83.18 / $91.20	Professional		$37.15	$83.18	$91.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $30.20 / $32.36	Professional	26	$18.62	$30.20	$32.36
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $52.48 / $60.26	Professional	TC	$18.20	$52.48	$60.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.11 / $33.11	Professional	26	$33.11	$33.11	$33.11
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	TC	$54.95	$54.95	$54.95
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $51.29 / $83.18	Professional		$23.44	$51.29	$83.18
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $19.05 / $28.84	Professional	26	$10.00	$19.05	$28.84
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $33.11 / $54.95	Professional	TC	$13.18	$33.11	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $37.15 / $79.43	Professional		$21.38	$37.15	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.98 / $29.51	Professional	26	$9.55	$16.98	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $21.38 / $50.12	Professional	TC	$10.96	$21.38	$50.12
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