Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	26	$30.90	$30.90	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $131.83	Professional		$60.26	$70.79	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.90 / $53.70	Professional	26	$25.70	$30.90	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $43.65 / $77.62	Professional	TC	$33.88	$43.65	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $162.18 / $204.17	Professional		$131.83	$162.18	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $70.79 / $89.13	Professional	26	$57.54	$70.79	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $91.20 / $114.82	Professional	TC	$74.13	$91.20	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $128.82 / $501.19	Professional		$67.61	$128.82	$501.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $56.23 / $323.59	Professional	26	$31.62	$56.23	$323.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $81.28 / $323.59	Professional	TC	$42.66	$81.28	$323.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $147.91 / $147.91	Professional		$134.90	$147.91	$147.91
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $72.44 / $72.44	Professional	26	$60.26	$72.44	$72.44
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $75.86 / $81.28	Professional	TC	$74.13	$75.86	$81.28
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $141.25	Professional		$81.28	$114.82	$141.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $58.88	Professional	26	$33.88	$48.98	$58.88
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $64.57 / $89.13	Professional	TC	$45.71	$64.57	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $186.21	Professional		$72.44	$120.23	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $48.98 / $69.18	Professional	26	$31.62	$48.98	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $66.07 / $114.82	Professional	TC	$41.69	$66.07	$114.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $141.25 / $141.25	Professional		$120.23	$141.25	$141.25
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $63.10 / $63.10	Professional	26	$53.70	$63.10	$63.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $79.43 / $79.43	Professional	TC	$67.61	$79.43	$79.43