Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.08 / $24.08 / $24.08	Facility	26	$24.08	$24.08	$24.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.65 / $82.34 / $179.78	Professional		$48.65	$82.34	$179.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $24.08 / $90.78	Professional	26	$18.01	$24.08	$90.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.72 / $64.31 / $152.19	Professional	TC	$25.72	$64.31	$152.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.13 / $116.36 / $145.44	Professional		$76.13	$116.36	$145.44
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 $41.11 / $62.83 / $78.54	Professional	TC	$41.11	$62.83	$78.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.44 / $90.21 / $575.66	Professional		$49.44	$90.21	$575.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.31 / $45.90 / $232.81	Professional	26	$27.31	$45.90	$232.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.82 / $44.31 / $398.91	Professional	TC	$25.82	$44.31	$398.91
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $62.35 / $62.35 / $62.35	Facility	26	$62.35	$62.35	$62.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $107.07 / $127.50	Professional		$93.11	$107.07	$127.50
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.15 / $82.38 / $97.04	Professional		$58.15	$82.38	$97.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.62 / $39.72 / $45.28	Professional	26	$24.62	$39.72	$45.28
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.43 / $43.99 / $51.75	Professional	TC	$28.43	$43.99	$51.75
United Facility/Professional Professional Modifier Low / Median / High Price $53.13 / $59.12 / $102.26	Professional		$53.13	$59.12	$102.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $31.40 / $49.66	Professional	26	$25.26	$31.40	$49.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.82 / $31.56 / $46.94	Professional	TC	$25.82	$31.56	$46.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $88.90 / $104.60 / $104.60	Professional		$88.90	$104.60	$104.60
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 $47.40 / $55.80 / $55.80	Professional	TC	$47.40	$55.80	$55.80