Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $42.66 / $42.66	Facility	26	$30.90	$42.66	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $104.71 / $354.81	Professional		$51.29	$104.71	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $43.65 / $104.71	Professional	26	$26.92	$43.65	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $26.30 / $173.78	Professional	TC	$10.00	$26.30	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $158.49	Professional		$100.00	$125.89	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $100.00 / $125.89	Professional	26	$69.18	$100.00	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.12 / $31.62	Professional	TC	$20.42	$25.12	$31.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $154.88 / $562.34	Professional		$79.43	$154.88	$562.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $50.12 / $263.03	Professional	26	$32.36	$50.12	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $117.49 / $426.58	Professional	TC	$54.95	$117.49	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $199.53 / $199.53	Professional		$107.15	$199.53	$199.53
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $91.20	Professional	26	$74.13	$74.13	$91.20
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $125.89 / $125.89	Professional	TC	$20.89	$125.89	$125.89
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $194.98	Professional		$69.18	$102.33	$194.98
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $69.18 / $83.18	Professional	26	$38.90	$69.18	$83.18
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.89 / $141.25	Professional	TC	$15.14	$20.89	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $144.54 / $257.04	Professional		$64.57	$144.54	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $51.29 / $89.13	Professional	26	$33.88	$51.29	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $87.10 / $190.55	Professional	TC	$13.18	$87.10	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $112.20	Professional		$95.50	$112.20	$112.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $89.13 / $89.13	Professional	26	$75.86	$89.13	$89.13
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $22.39 / $22.39	Professional	TC	$19.05	$22.39	$22.39