Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.32 / $24.32 / $24.32	Facility	26	$24.32	$24.32	$24.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $45.71 / $75.45	Professional		$41.75	$45.71	$75.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $45.82 / $118.37	Professional	26	$22.60	$45.82	$118.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.52 / $43.86 / $117.90	Professional	TC	$22.52	$43.86	$117.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.98 / $102.39 / $127.99	Professional		$66.98	$102.39	$127.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.02 / $53.52 / $66.90	Professional	26	$35.02	$53.52	$66.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.97 / $48.87 / $61.09	Professional	TC	$31.97	$48.87	$61.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $86.86 / $495.56	Professional		$48.44	$86.86	$495.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.26 / $46.57 / $151.44	Professional	26	$28.26	$46.57	$151.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.02 / $40.29 / $367.63	Professional	TC	$25.02	$40.29	$367.63
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $78.58 / $78.58 / $78.58	Facility	26	$78.58	$78.58	$78.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.94 / $100.64 / $114.09	Professional		$93.94	$100.64	$114.09
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $74.90 / $85.39	Professional		$55.31	$74.90	$85.39
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.72 / $39.72 / $45.28	Professional	26	$29.72	$39.72	$45.28
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.68 / $35.18 / $40.57	Professional	TC	$24.68	$35.18	$40.57
United Facility/Professional Professional Modifier Low / Median / High Price $53.28 / $81.86 / $96.88	Professional		$53.28	$81.86	$96.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.63 / $33.68 / $51.38	Professional	26	$25.63	$33.68	$51.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.02 / $29.64 / $45.50	Professional	TC	$25.02	$29.64	$45.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.30 / $92.10 / $92.10	Professional		$78.30	$92.10	$92.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.50 / $48.80 / $48.80	Professional	26	$41.50	$48.80	$48.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $36.79 / $43.20 / $43.20	Professional	TC	$36.79	$43.20	$43.20