Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $33.11 / $33.11	Facility	26	$23.99	$33.11	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $87.10 / $177.83	Professional		$38.90	$87.10	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $56.23 / $91.20	Professional	26	$30.20	$56.23	$91.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.18 / $69.18 / $70.79	Professional	50	$69.18	$69.18	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $33.11 / $169.82	Professional	TC	$9.33	$33.11	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $190.55	Professional		$97.72	$151.36	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $75.86 / $95.50	Professional	26	$52.48	$75.86	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $75.86 / $95.50	Professional	TC	$48.98	$75.86	$95.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $363.08	Professional		$42.66	$70.79	$363.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $46.77 / $199.53	Professional	26	$24.55	$46.77	$199.53
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $24.55 / $213.80	Professional	TC	$13.49	$24.55	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $128.82 / $138.04	Professional		$125.89	$128.82	$138.04
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $69.18	Professional	26	$57.54	$57.54	$69.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $70.79 / $70.79	Professional	TC	$58.88	$70.79	$70.79
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $93.33 / $125.89	Professional		$51.29	$93.33	$125.89
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $52.48 / $63.10	Professional	26	$30.20	$52.48	$63.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $51.29 / $61.66	Professional	TC	$13.80	$51.29	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $112.20	Professional		$42.66	$70.79	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.90 / $69.18	Professional	26	$25.12	$38.90	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $31.62 / $61.66	Professional	TC	$13.49	$31.62	$61.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $134.90	Professional		$114.82	$134.90	$134.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $69.18 / $69.18	Professional	26	$57.54	$69.18	$69.18
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $66.07 / $66.07	Professional	TC	$56.23	$66.07	$66.07