Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $23.99 / $23.99	Facility	26	$23.99	$23.99	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $275.42	Professional		$41.69	$66.07	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $50.12 / $117.49	Professional	26	$22.39	$50.12	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $33.11 / $117.49	Professional	TC	$19.95	$33.11	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $131.83	Professional		$83.18	$104.71	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $54.95 / $69.18	Professional	26	$43.65	$54.95	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $50.12 / $63.10	Professional	TC	$38.02	$50.12	$63.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $85.11 / $501.19	Professional		$42.66	$85.11	$501.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $47.86 / $151.36	Professional	26	$25.70	$47.86	$151.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.90 / $371.54	Professional	TC	$22.91	$38.90	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $107.15	Professional		$89.13	$107.15	$107.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $58.88 / $58.88	Professional	26	$47.86	$58.88	$58.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $47.86	Professional	TC	$40.74	$47.86	$47.86
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $74.13 / $89.13	Professional		$54.95	$74.13	$89.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $39.81 / $45.71	Professional	26	$29.51	$39.81	$45.71
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $35.48 / $41.69	Professional	TC	$24.55	$35.48	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $72.44 / $104.71	Professional		$47.86	$72.44	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.90 / $54.95	Professional	26	$25.12	$38.90	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $57.54	Professional	TC	$22.91	$36.31	$57.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $91.20	Professional		$77.62	$91.20	$91.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $48.98 / $48.98	Professional	26	$41.69	$48.98	$48.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $43.65	Professional	TC	$37.15	$43.65	$43.65