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 $53.47 / $112.65 / $167.84	Professional		$53.47	$112.65	$167.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.92 / $39.18 / $117.48	Professional	26	$25.92	$39.18	$117.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.15 / $85.82 / $162.00	Professional	TC	$32.15	$85.82	$162.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.37 / $141.18 / $176.47	Professional		$92.37	$141.18	$176.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $62.83 / $78.54	Professional	26	$41.11	$62.83	$78.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.26 / $78.34 / $97.93	Professional	TC	$51.26	$78.34	$97.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.91 / $109.15 / $562.97	Professional		$59.91	$109.15	$562.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.66 / $53.48 / $186.58	Professional	26	$31.66	$53.48	$186.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.92 / $55.67 / $399.92	Professional	TC	$32.92	$55.67	$399.92
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $92.57 / $92.57 / $92.57	Facility	26	$92.57	$92.57	$92.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.77 / $131.38 / $155.00	Professional		$113.77	$131.38	$155.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $70.33 / $99.82 / $117.74	Professional		$70.33	$99.82	$117.74
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.75 / $46.33 / $53.05	Professional	26	$34.75	$46.33	$53.05
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $35.89 / $54.99 / $64.69	Professional	TC	$35.89	$54.99	$64.69
United Facility/Professional Professional Modifier Low / Median / High Price $65.54 / $106.20 / $169.48	Professional		$65.54	$106.20	$169.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.66 / $44.99 / $57.56	Professional	26	$31.66	$44.99	$57.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.92 / $39.51 / $59.86	Professional	TC	$32.92	$39.51	$59.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.90 / $126.90 / $126.90	Professional		$107.90	$126.90	$126.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $48.60 / $57.20 / $57.20	Professional	26	$48.60	$57.20	$57.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $59.30 / $69.80 / $69.80	Professional	TC	$59.30	$69.80	$69.80