Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.81 / $27.81 / $27.81	Facility	26	$27.81	$27.81	$27.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.05 / $88.15 / $127.89	Professional		$51.05	$88.15	$127.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $27.36 / $75.65	Professional	26	$24.87	$27.36	$75.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.53 / $25.53 / $77.16	Professional	52	$25.53	$25.53	$77.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $63.28 / $91.70	Professional	TC	$27.38	$63.28	$91.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $134.19 / $167.75	Professional		$88.68	$134.19	$167.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $61.28 / $76.59	Professional	26	$40.09	$61.28	$76.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.82 / $72.92 / $91.14	Professional	TC	$55.82	$72.92	$91.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.73 / $147.19 / $447.95	Professional		$88.73	$147.19	$447.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.68 / $53.48 / $265.83	Professional	26	$29.68	$53.48	$265.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.79 / $93.72 / $398.99	Professional	TC	$60.79	$93.72	$398.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $86.74 / $86.74 / $86.74	Facility	26	$86.74	$86.74	$86.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.00 / $161.82 / $198.38	Professional		$117.00	$161.82	$198.38
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $82.07 / $106.94 / $144.47	Professional		$82.07	$106.94	$144.47
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $44.54 / $52.40	Professional	26	$33.15	$44.54	$52.40
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.85 / $60.16 / $99.21	Professional	TC	$44.85	$60.16	$99.21
United Facility/Professional Professional Modifier Low / Median / High Price $68.30 / $129.58 / $178.42	Professional		$68.30	$129.58	$178.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.68 / $36.60 / $54.64	Professional	26	$29.68	$36.60	$54.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.34 / $74.67 / $124.46	Professional	TC	$36.34	$74.67	$124.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $121.40 / $121.40	Professional		$103.20	$121.40	$121.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $48.00 / $56.50 / $56.50	Professional	26	$48.00	$56.50	$56.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $55.10 / $64.90 / $64.90	Professional	TC	$55.10	$64.90	$64.90